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Rectal Injury

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Civilian extraperitoneal rectal gunshot wounds: surgical management made simpler.
Navsaria PH, Edu S, Nicol AJ.
World J Surg. 2007 Jun;31(6):1345-51.

Rationale for inclusion: This retrospective review advocated for the treatment of low velocity penetrating extraperitoneal rectal injuries with fecal diversion alone, without need for repair or presacral drainage.

Citations - 46 (as of July 2017)

Penetrating rectal trauma: management by anatomic distinction imp
Weinberg JA, Fabian TC, Magnotti LJ, Minard G, Bee TK, Edwards N, Claridge JA, Croce MA.
J Trauma. 2006 Mar;60(3):508-13; discussion 513-14.

Rationale for inclusion: Using 54 patients with penetrating rectal injuries, this study advocated for the use of primary repair for intraperitoneal injuries, repair and fecal diversion for accessible extraperitonal injuries, and diversion with presacral drainage for injuries in the extraperitoneal rectum not amenable to repair.

Citations - 63 (as of July 2017)

The role of presacral drainage in the management of penetrating rectal injuries.
Gonzalez RP, Falimirski ME, Holevar MR.
J Trauma. 1998 Oct;45(4):656-61.

Rationale for inclusion: A randomized prospective study, this trial concluded that the addition of presacral drainage for penetrating rectal injuries has no benefit in reduction of infectious complications and can be avoided.

Citations - 82 (as of July 2017)

Colostomy and drainage for civilian rectal injuries: is that all?
Burch JM, Feliciano DV, Mattox KL.
Ann Surg. 1989 May;209(5):600-10; discussion 610-1.

Rationale for inclusion: This series of 100 consecutive patients with extraperitonal rectal injuries treated in the 1980s described the need for colostomy and presacral drainage as mainstays of treatment for this injury pattern.

Citations - 158 (as of July 2017)

The management of perforating injuries of the colon and rectum in civilian practice.
Woodhall JP, Ochsner A.
Surgery. 1951 Feb;29(2):305-20.

Rationale for inclusion: This series of 55 patients with perforating injuries to the rectum and colon remains one of the initial case series documenting 20% mortality, with the lowest mortality achieved with primary repair alone as compared to proximal decompression or exteriorization.

Citations - 167 (as of July 2017)

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