PDF(Pubmed)
Abstract：
BACKGROUND: A rectal impalement injury is a rare type of penetrating injury that involves a solid object being forcefully inserted through anal opening. The removal of such injuries should be planned carefully with preparedness to assess and manage associated injuries in the pelvis and peri-anal region.
METHODS: An elderly female, around 65 years old, had a history of accidental penetration of an iron rod into her anal orifice. The patient was hemodynamically stable, and the distal end of the penetrated rod was visible in the anal verge on arrival. On evaluation, we found that the object had perforated the posterior wall of the middle 1/3rd of the rectum and had traversed retroperitoneally, bypassing all major vessels and viscera.
CONCLUSIONS: We performed exploratory laparotomy, and the iron rod was extracted from the anal canal under vision, and a diversion colostomy of the sigmoid colon was performed. The patient had an uneventful recovery, and the reversal of the sigmoid colostomy was done after 3 months.
CONCLUSIONS: Rectal impalement injuries are rare and serious. It requires a multidisciplinary approach involving a general surgeon, a vascular surgeon, and a urologist since it is associated with a higher incidence of involving major pelvic organs and vessels. In our case, the penetrating object had bypassed all major vessels, which is a rare occurrence.
METHODS: An elderly female, around 65 years old, had a history of accidental penetration of an iron rod into her anal orifice. The patient was hemodynamically stable, and the distal end of the penetrated rod was visible in the anal verge on arrival. On evaluation, we found that the object had perforated the posterior wall of the middle 1/3rd of the rectum and had traversed retroperitoneally, bypassing all major vessels and viscera.
CONCLUSIONS: We performed exploratory laparotomy, and the iron rod was extracted from the anal canal under vision, and a diversion colostomy of the sigmoid colon was performed. The patient had an uneventful recovery, and the reversal of the sigmoid colostomy was done after 3 months.
CONCLUSIONS: Rectal impalement injuries are rare and serious. It requires a multidisciplinary approach involving a general surgeon, a vascular surgeon, and a urologist since it is associated with a higher incidence of involving major pelvic organs and vessels. In our case, the penetrating object had bypassed all major vessels, which is a rare occurrence.
摘要：
背景：直肠穿刺损伤是一种罕见的穿透性损伤，涉及通过肛门开口强行插入固体物体。应仔细计划去除此类损伤，并准备评估和管理骨盆和肛周区域的相关损伤。
方法：一位老年女性，大约65岁，有一根铁棒意外刺入她的肛口的病史.病人血流动力学稳定,并且在到达时在肛门边缘可以看到穿透的杆的远端。关于评估，我们发现该物体穿孔了直肠中部1/3的后壁，并穿过腹膜后，绕过所有主要血管和内脏.
结论：我们进行了剖腹探查术，铁棒是在视觉下从肛管中取出的，进行乙状结肠分流结肠造口术。病人恢复顺利，3个月后进行乙状结肠造口术的逆转。
结论：直肠穿刺损伤罕见且严重。它需要涉及普通外科医生的多学科方法，血管外科医生,和泌尿科医生，因为它与累及主要盆腔器官和血管的发病率较高有关。在我们的案例中,穿透物体绕过了所有主要船只，这是罕见的。
方法：一位老年女性，大约65岁，有一根铁棒意外刺入她的肛口的病史.病人血流动力学稳定,并且在到达时在肛门边缘可以看到穿透的杆的远端。关于评估，我们发现该物体穿孔了直肠中部1/3的后壁，并穿过腹膜后，绕过所有主要血管和内脏.
结论：我们进行了剖腹探查术，铁棒是在视觉下从肛管中取出的，进行乙状结肠分流结肠造口术。病人恢复顺利，3个月后进行乙状结肠造口术的逆转。
结论：直肠穿刺损伤罕见且严重。它需要涉及普通外科医生的多学科方法，血管外科医生,和泌尿科医生，因为它与累及主要盆腔器官和血管的发病率较高有关。在我们的案例中,穿透物体绕过了所有主要船只，这是罕见的。
