scholarly journals Severe Hemoperitoneum after Patient Self-Induced Fecal Evacuation

2011 ◽  
Vol 2011 ◽  
pp. 1-3
Author(s):  
S. Gianesini ◽  
S. Lanzara ◽  
R. Stano ◽  
S. Santini ◽  
A. De Troia ◽  
...  
Keyword(s):  
Hemorrhagic Shock ◽  
Clinical Case ◽  
Primary Repair ◽  
Fecal Diversion ◽  
Surgeon General ◽  
Anastomotic Breakdown ◽  
Resection And Anastomosis ◽  
Intestinal Diversion ◽  
Rectal Injuries

An increasing incidence of rectal injuries following patient self-induced harmful acts, aimed to sexual or laxatives porpouses, is a fact reported in literature (El-Ashaal et al., 2008). We herein report a case of severe hemoperitoneum related to a middle and upper rectal third seromuscolar tear caused by a self-induced fecal evacuation by means of an arrow with a covered cork tip. An urgent intestinal diversion by means of a Hartmann's operation was performed. The clinical case is presented in relation to the literature debate, regarding the issue of primary repair or resection and anastomosis versus fecal diversion for penetrating rectal injuries (Fabian, 2002; Cleary et al., 2006; Office of the Surgeon General, 1943; Busic et al., 2002). In conclusion, the importance of avoiding an anastomotic breakdown in a patient undergoing a hemorrhagic shock is highlighted.

scholarly journals Outcomes of Primary Repair and Anastomosis for Traumatic Colonic Injuries in a Tertiary Trauma Center

Medicina ◽  
2020 ◽  
Vol 56 (9) ◽  
pp. 440
Author(s):  
Marie Shella De Robles ◽  
Christopher J. Young
Keyword(s):  
Surgical Management ◽  
Trauma Center ◽  
Primary Repair ◽  
Length Of Hospital Stay ◽  
Injury Mechanism ◽  
Complication Rates ◽  
Colonic Injury ◽  
Significant Difference ◽  
Injured Part ◽  
Resection And Anastomosis

Background: Surgical management for traumatic colonic injuries has undergone major changes in the past decades. Despite the increasing confidence in primary repair for both penetrating colonic injury (PCI) and blunt colonic injury (BCI), there are authors still advocating for a colostomy particularly for BCI. This study aims to describe the surgical management of colonic injuries in a level 1 metropolitan trauma center and compare patient outcomes between PCI and BCI. Methods: Twenty-one patients who underwent trauma laparotomy for traumatic colonic injuries between January 2011 and December 2018 were retrospectively reviewed. Results: BCI accounted for 67% and PCI for 33% of traumatic colonic injuries. The transverse colon was the most commonly injured part of the colon (43%), followed by the sigmoid colon (33%). Primary repair (52%) followed by resection-anastomosis (38%) remain the most common procedures performed regardless of the injury mechanism. Only two (10%) patients required a colostomy. There was no significant difference comparing patients who underwent primary repair, resection-anastomosis and colostomy formation in terms of complication rates (55% vs. 50% vs. 50%, p = 0.979) and length of hospital stay (21 vs. 21 vs. 19 days, p = 0.991). Conclusions: Regardless of the injury mechanism, either primary repair or resection and anastomosis is a safe method in the management of the majority of traumatic colonic injuries.

scholarly journals Minimally invasive approach to low-velocity penetrating extraperitoneal rectal trauma

2020 ◽  
Vol 5 (1) ◽  
pp. e000396
Author(s):  
Megan Melland-Smith ◽  
Tyler R Chesney ◽  
Shady Ashamalla ◽  
Fred Brenneman
Keyword(s):  
Minimally Invasive ◽  
New Technologies ◽  
Primary Repair ◽  
Standard Of Care ◽  
Rectal Disease ◽  
Low Velocity ◽  
Invasive Approach ◽  
Rectal Trauma ◽  
Rectal Injuries ◽  
Diverting Colostomy

Unlike intraperitoneal colorectal injuries, the standard of care for extraperitoneal rectal trauma includes a diverting colostomy due to relative inaccessibility of these injuries for primary repair. New technologies to enhance access to the extraperitoneal rectum have gained increasing use in benign and malignant rectal disease. We present two cases of low-velocity penetrating extraperitoneal rectal trauma. In both cases, a transanal minimally invasive surgery (TAMIS) approach was used to access, and primarily repair, full-thickness rectal lacerations. These patients were successfully managed without a colostomy and without complication. TAMIS enables access to distal rectal injuries, facilitating primary repair and bringing the management of extraperitoneal rectal injuries in line with intraperitoneal injuries, with the potential to avoid fecal diversion.

scholarly journals Colonic injuries; is primary repair a safe option?

2016 ◽  
Vol 12 (2) ◽  
Author(s):  
Intesarur Rashid Khan ◽  
Khalid Irshad ◽  
Muhammad Akmal Shafiq ◽  
Bahzad Akram Khan ◽  
Abdul Majeed Cuahdhry
Keyword(s):  
Primary Repair ◽  
Fecal Diversion ◽  
Ileocolic Anastomosis ◽  
Inclusion Criteria ◽  
Exclusion Criteria ◽  
Safe Option

Objectives: This study was conducted at Mayo Hospital, Lahore from April 2004 to May 2005 to compare the results of primary repair and exteriorization in cases of large gut injuries .Materials and methods: :80 patients, presenting in emergency between Jan. 2004 and December 2005, were selected out of which 63 were males and 17 were females. Colonic injuries were divided into five categories and were dealt accordingly. Inclusion criteria: All colonic injuries presenting to emergency in study period except. Exclusion criteria: Injuries requiring ileocolic anastomosis, repair and proximal fecal diversion and distal colonic injuries requiring Hartmann`s procedure.

scholarly journals Direct site endovascular repair as salvage procedure after anastomotic breakdown of primary repair following trauma

2019 ◽  
Vol 5 (4) ◽  
pp. 597-601
Author(s):  
Anders J. Davidson ◽  
Marta J. Madurska ◽  
Benjamin Moran ◽  
Jonathan J. Morrison ◽  
Joseph J. DuBose ◽  
...  
Keyword(s):  
Endovascular Repair ◽  
Primary Repair ◽  
Salvage Procedure ◽  
Anastomotic Breakdown

scholarly journals A Very Unlikely Finding in a Male Child: Urethral Prolapse

2017 ◽  
Vol 05 (01) ◽  
pp. e36-e38
Author(s):  
Çiğdem Durakbaşa ◽  
Gonca Gercel ◽  
Murat Mutus ◽  
Burhan Aksu ◽  
Seyma Ozkanli
Keyword(s):  
Undescended Testis ◽  
Primary Repair ◽  
Black Girls ◽  
Pathological Examination ◽  
Undescended Testes ◽  
Predisposing Factor ◽  
Benign Condition ◽  
Urethral Prolapse ◽  
Stratified Squamous Epithelium ◽  
Resection And Anastomosis

AbstractUrethral prolapse is a disease of prepubertal black girls and postmenopausal women with an unknown cause. It may be congenital in origin or an acquired condition. It has never been reported in males. We report a 10-year-old Caucasian boy who presented because of recurrent right undescended testis. He had been operated on for bilateral undescended testes 7 years ago in another hospital, and circumcision was done during the same operation. The boy complained of a weak urinary stream during voiding. The physical examination was consistent with recurrent right undescended testis. Penile examination showed a circumferential urethral prolapse around the meatus. The urethral meatal appearance was apparent right after the circumcision. An orchiopexy operation as well as circumferential excision of the perimeatal urethral tissue with primary repair was done. The pathological examination of the specimen revealed keratinized stratified squamous epithelium consistent with urethral mucosa. The postoperative course was uneventful, and the patient urinates normally at the 8 postoperative month with a normal uroflowmetry study. This is the first report of urethral prolapse in a male. Because circumcision is a widely employed practice in many cultures, it is unlikely to be a predisposing factor. It is a benign condition that can be cured with simple resection and anastomosis.

Management of selected rectal injuries by primary repair

1996 ◽  
Vol 172 (5) ◽  
pp. 575-579 ◽  
Author(s):  
Jeffrey H. Levine ◽  
Walter E. Longo ◽  
Christopher Pruitt ◽  
John E. Mazuski ◽  
Marc J. Shapiro ◽  
...  
Keyword(s):  
Primary Repair ◽  
Rectal Injuries

scholarly journals Morbidity predicting factors of penetrating colon injuries

2010 ◽  
Vol 57 (3) ◽  
pp. 55-58 ◽  
Author(s):  
A. Mickevicius ◽  
G. Valeikaite ◽  
A. Tamelis ◽  
Z. Saladzinskas ◽  
S. Svagzdys ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Postoperative Complications ◽  
Systolic Blood Pressure ◽  
Peritoneal Cavity ◽  
Primary Repair ◽  
Group Analysis ◽  
Fecal Contamination ◽  
Significant Risk ◽  
Fecal Diversion ◽  
Colon Injuries

THE AIM of this study was to analyze patients suffering from penetrating colon injuries management, clinical outcomes and factors, which predict higher morbidity and complications rate. METHODS: this was a retrospective analysis of prospectively collected data from patients with injured colon from 1995 to 2008. Age, time till operation, systolic blood pressure, part of injured colon, fecal contamination, PATI were registered. Monovariate and multivariate logistic regression was performed to determine higher morbidity predictive factors. RESULTS: 61 patients had penetrating colon injuries. Major fecal contamination of the peritoneal cavity and systolic blood pressure lower than 90 mmHg are independent factors determining the fecal diversion operation. Primary repair group analysis establish that major fecal contamination and systolic blood pressure lower than 90 mmHg OR=4,2 and 0,96 were significant risk factors, which have contributed to the development of postoperative complications. And systolic blood pressure lower than 90 mmHg and PATI 20 predict OR=0,05 and 2,61 higher morbidity. CONCLUSIONS: Fecal contamination of the peritoneal cavity and hypotension were determined to be crucial in choice of performing fecal diversion or primary repair. But the same criteria and PATI predict higher rate of postoperative complications and higher morbidity.

scholarly journals COMPARATIVE ANALYSIS OF PRIMARY REPAIR VERSUS RESECTION AND ANASTOMOSIS IN JEJUNOILEAL PERFORATIONS IN SOUTHERN ODISHA

2017 ◽  
Vol 4 (91) ◽  
pp. 5507-5511
Author(s):  
Charan Panda ◽  
Asutosh Hotta ◽  
Bhagaban Panda ◽  
Manas Ranjan Behera ◽  
Sanjit Kumar Nayar ◽  
...  
Keyword(s):  
Comparative Analysis ◽  
Primary Repair ◽  
Resection And Anastomosis
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