Simplified management of low-energy projectile extraperitoneal rectal injuries.

Publication/Presentation Date

12-1-2009

Abstract

INTRODUCTION: Since minimally invasive approach for fecal diversion in low-velocity extraperitoneal rectal injuries (EPRI) has a lower morbidity than open, and since computed tomography (CT) scan is helpful in ruling out concomitant intraperitoneal injuries (IPI), we utilized both modalities to simplify management of such injuries.

METHODS: Retrospective review of stable patients with EPRI, treated with laparoscopic assisted diversion, after a CT scan, compared with patients with similar injuries that had a negative laparotomy and a colostomy.

RESULTS: The laparoscopy group had a shorter length of stay (3 +/- 2 days versus 7 +/- 2 days), earlier return of bowel function (3 +/- 2 days versus 5 +/- 2 days) and fewer infectious complications. If the CT scan was negative for IPI, none were found on open exploration or laparoscopy.

CONCLUSION: If IPI are ruled out with a preoperative CT scan, laparoscopy-assisted colostomy is safe and less morbid.

Volume

67

Issue

6

First Page

1270

Last Page

1271

ISSN

1529-8809

Disciplines

Medicine and Health Sciences

PubMedID

19680157

Department(s)

Department of Surgery

Document Type

Article

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