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. 2009 Dec;67(6):1270-1.
doi: 10.1097/TA.0b013e318187ad14.

Simplified management of low-energy projectile extraperitoneal rectal injuries

Naveed Ahmed  1 , Sanjay Thekkeurumbil, Viney Mathavan, Mark Janzen, James Tasse, Raphael Chung
Affiliations

Simplified management of low-energy projectile extraperitoneal rectal injuries

Naveed Ahmed et al. J Trauma. 2009 Dec.

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.

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