MANAGEMENT OF FOREIGN-BODIES AND TRAUMA OF THE RECTUM

  • 1 January 1983
    • journal article
    • research article
    • Vol. 156  (4) , 453-457
Abstract
A series of 101 patients with trauma of the rectum, secondary to homosexual practices, is reviewed. Two patients were injured twice. Some 36 patients retained foreign bodies in the rectum, 55 had lacerations of the mucosa, 2 had disruptions of the anal sphincter and 10 had perforations of the rectosigmoid. The majority of retained foreign bodies can be removed on an outpatient basis. If removal is not immediately possible, the patient should be admitted for observation and removal of the foreign body transanally under anesthesia. Routine sigmoidoscopic examination is performed after removal. Removal seldom requires laparotomy. Simple nonbleeding lacerations of the mucosa can be managed on an outpatient basis. Patients with abdominal pain, fever, continued bleeding, large lacerations or tear of the sphincter should be admitted and observed or operated on, or both, as needed. Serious injuries, secondary to homosexual acts, can and do occur, as evidenced by the mortality reported in this series. Perforations of the rectosigmoid above the peritoneal reflection can be treated by laparotomy, repair of the perforation, removal of gross contamination by irrigation, proximal loop colostomy and appropriate antibiotic therapy. Perforations below the peritoneal reflection are challenging instances which require individualized management.

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