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Rectal Trauma

Rectal Trauma is a topic covered in the 5-Minute Emergency Consult.

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Emergency Central

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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
      • 50% mortality
    • Colonoscopy:
      • 0.2% perforation rate
      • Increased risk with polypectomy
    • Hemorrhoidectomy
    • Urologic and Ob-Gyn procedures:
      • Episiotomy

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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Citation

Rosen, Peter, et al., editors. "Rectal Trauma." 5-Minute Emergency Consult, 5th ed., Lippincott Williams & Wilkins, 2016. Emergency Central, emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307403/all/Rectal_Trauma.
Rectal Trauma. In: Rosen P, Shayne P, Barkin AZ, et al, eds. 5-Minute Emergency Consult. 5th ed. Lippincott Williams & Wilkins; 2016. https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307403/all/Rectal_Trauma. Accessed April 22, 2019.
Rectal Trauma. (2016). In Rosen, P., Shayne, P., Barkin, A. Z., Wolfe, R. E., Hayden, S. R., Barkin, R. M., & Schaider, J. J. (Eds.), 5-Minute Emergency Consult. Available from https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307403/all/Rectal_Trauma
Rectal Trauma [Internet]. In: Rosen P, Shayne P, Barkin AZ, Wolfe RE, Hayden SR, Barkin RM, Schaider JJ, editors. 5-Minute Emergency Consult. Lippincott Williams & Wilkins; 2016. [cited 2019 April 22]. Available from: https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307403/all/Rectal_Trauma.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC T1 - Rectal Trauma ID - 307403 ED - Rosen,Peter, ED - Shayne,Philip, ED - Barkin,Adam Z, ED - Wolfe,Richard E, ED - Hayden,Stephen R, ED - Barkin,Roger M, ED - Schaider,Jeffrey J, BT - 5-Minute Emergency Consult UR - https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307403/all/Rectal_Trauma PB - Lippincott Williams & Wilkins ET - 5 DB - Emergency Central DP - Unbound Medicine ER -