ABDOMINOPERINEAL RESECTION IN TREATMENT OF DE-VASCULARIZING RECTAL INJURIES

  • 1 January 1977
    • journal article
    • research article
    • Vol. 82  (3) , 310-313
Abstract
Local debridment, drainage and diverting colostomy, with or without primary repair of the rectum, were considered to be the standard treatment for most rectal injuries, but they are not sufficient for those patients sustaining uncontrollable bleeding or extensive rectal devascularization. The indications and results of abdominoperineal resection of the rectum were assessed in these patients. Patients (10) who were victims of explosive trauma presented with massive perineal injuries and extensive rectal devascularization. Six of these were treated with local debridment of necrotic tissue, pararectal drainage, antibiotics and colostomy. Of the 6 patients initially treated by colostomy, 5 died after operation from hemorrhage or sepsis. The 6th patient, who survived, had an abdominal resection of the rectum performed 5 days after the colostomy for removal of a gangrenous rectum. All 5 of those who underwent abdominoperineal resection survived (P < 0.01). The need for careful investigation of rectal viability is emphasized. Primary abdominoperineal resection of the rectum is advised when extensive devascularization has occurred.

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