Rectal Trauma
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Basics
Description
- Injury to rectal mucosa
- Simple contusion to full-thickness laceration with extension into peritoneum or perineum
- 2/3 of rectum is extraperitoneal
Etiology
- Penetrating trauma:
- Gunshot wounds: 80% penetrating rectal trauma
- Knife wounds
- Impalement injuries
- Blunt trauma:
- Motor vehicle accidents
- Waterskiing and watercraft accidents:
- Hydrostatic pressure injury
- Pelvic fractures:
- Bony fragments penetrate rectum
- Foreign body:
- Autoeroticism
- Anal intercourse
- Assault
- Ingestion of sharp objects
- Iatrogenic trauma: Most common cause of rectal injury:
- Barium enema:
- Perforation occurs in 0.04% patients
- Up to 35% mortality
- Colonoscopy:
- 0.2% perforation rate
- Increased risk with polypectomy
- Hemorrhoidectomy
- Urologic and OB/GYN procedures:
- Episiotomy
- Barium enema:
Pediatric Considerations
- Rectal injury may result from thermometer insertion
- Any rectal trauma in young children should raise the suspicion of nonaccidental trauma
-- To view the remaining sections of this topic, please log in or purchase a subscription --
Basics
Description
- Injury to rectal mucosa
- Simple contusion to full-thickness laceration with extension into peritoneum or perineum
- 2/3 of rectum is extraperitoneal
Etiology
- Penetrating trauma:
- Gunshot wounds: 80% penetrating rectal trauma
- Knife wounds
- Impalement injuries
- Blunt trauma:
- Motor vehicle accidents
- Waterskiing and watercraft accidents:
- Hydrostatic pressure injury
- Pelvic fractures:
- Bony fragments penetrate rectum
- Foreign body:
- Autoeroticism
- Anal intercourse
- Assault
- Ingestion of sharp objects
- Iatrogenic trauma: Most common cause of rectal injury:
- Barium enema:
- Perforation occurs in 0.04% patients
- Up to 35% mortality
- Colonoscopy:
- 0.2% perforation rate
- Increased risk with polypectomy
- Hemorrhoidectomy
- Urologic and OB/GYN procedures:
- Episiotomy
- Barium enema:
Pediatric Considerations
- Rectal injury may result from thermometer insertion
- Any rectal trauma in young children should raise the suspicion of nonaccidental trauma
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