Rectal injuries

Abstract

Injuries to the rectum have always been associated with a high mortality. This was reduced when exteriorization was introduced, particularly when it was combined with prompt and effective resuscitative measures. Experience gained during the Vietnam war demonstrated the considerable benefit of washout of the distal rectal segment. The author describes the course of management he advises. After initial resuscitation, roentgenography of the pelvis and abdomen is necessary. Antibiotics should be administered preoperatively. Through a midline incision the rectal wounds are repaired and a proximal diverting colostomy is performed. The nonfunctioning bowel segment should then be thoroughly washed out. Careful search must be made for associated injuries that require attention.