Home E-PUBLISHED 2016 Dicembre 2016 Blunt rectal trauma. Case report and literature review
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Blunt rectal trauma. Case report and literature review

Blunt rectal trauma. Case report and literature review

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Michele Marini, Giorgio Fratus, Pierluigi D’Amore, Fabio Tagliabue, Pierpaolo Mariani, Luisella Spinelli, Lorenzo Novellino
Ann Ital Chir, Digital Edition 2016 - Epub, Dec. 19

Blunt colorectal traumas are rare clinical entities with a challenging diagnostic and operative management.
We describe the case of a 40-year-old man, victim of an accidental fall from a height of four meters who was subsequently
diagnosed to have a blunt rectal trauma.
A first CT scan showed fracture of the skull and an extensive subcutaneous haematoma of the lower back associated
with a fracture of the left transverse processes of lumbar vertebrae. No other visceral abdominal lesions were recognized
and patient was admitted to our department for observational studies. After 48 hours from admission the patient presented
a subcutaneous emphysema suspicious for hollow viscus injuries. A digital rectal examination detected a laceration
both of the posterior rectal wall and the superior anal margin.
The patient was successfully managed with spur colostomy, transanal evacuation of the retroperitoneal haematoma and
primary repair of both the sphincteric muscle and the rectal wall. As soon as the patient achieved full recovery we performed
a reversal colostomy.
Diagnosis and management of rectal blunt trauma is still a matter of debate and no definitive recommendation treatments
are available. The surgical treatment should be tailored on patient medical conditions and clinicians should maintain
a high index of suspicious because a delay in diagnosis can result in higher morbidity and mortality rate.

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