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Lésions traumatiques de l'anorectum

Published in Swiss surgery. 1998, vol. 4, no. 5, p. 249-52
Abstract Injuries of the colon and rectum are common surgical problems. Lesions can be classified into four groups according to the site of damage and the presence of sphincter tears: 1. intraperitoneal perforation without sphincter damage 2. intraperitoneal perforation with sphincter damage 3. extraperitoneal perforation without sphincter damage 4. extraperitoneal perforation with sphincter damage From 1990 to 1998, 11 patients, 7 males and 4 females presenting an anal and/or rectal trauma were admitted in Geneva University Hospital. 8 patients were admitted as an emergency, the 3 others had been transferred to correct an incontinent post traumatic pathology. No mortality. A terminal colostomy was performed in all patients with intraperitoneal injury and in 5 patients with combined extraperitoneal and anal sphincter injury. All sphincter lesions were sutured as an emergency (6 cases). In 3 patients we performed an overlapping sphincteroplasty. 2 patients with persisting incontinence were cured by a dynamic stimulated graciloplasty. The choice of treatment of anorectal trauma includes broad spectrum antibiotherapy, cleaning of the rectum, sphincter repair. A terminal diverting colostomy and laparotomy must be achieved in case of intraperitoneal injury, large extraperitoneal lesion, severe perineal laceration with or without pelvic fracture.
Keywords Anal Canal/injuries/surgeryColon/injuries/surgeryColostomyFemaleHumansIntestinal Perforation/diagnosis/surgeryMaleRectum/injuries/surgeryTreatment Outcome
PMID: 9816936
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Research groups Groupe Bruno Roche (chirurgie colo-rectale) (92)
Traumatologie ostéoarticulaire (99)
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ROCHE, Bruno et al. Lésions traumatiques de l'anorectum. In: Swiss surgery, 1998, vol. 4, n° 5, p. 249-52. https://archive-ouverte.unige.ch/unige:74249

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