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J Trauma Inj > Volume 29(4); 2016 > Article
Journal of Trauma and Injury 2016;29(4):201-203.
DOI: https://doi.org/10.20408/jti.2016.29.4.201    Published online December 31, 2016.
Rectal Injury Associated with Pelvic Fracture
Jihun Gwak, Min A Lee, Byungchul Yu, Kang Kook Choi
Department of Trauma Surgery, Gachon University Gil Medical Center, Incheon, Korea. choikangkook@gilhospital.com
Received: 5 December 2016   • Revised: 10 December 2016   • Accepted: 17 February 2017
Abstract
Rectal injury is seen in 1-2% of all pelvic fractures, and lower urinary tract injury occurs in up to 7%. These injuries are rare, but if missed, can lead to a severe septic response. Rectal injury may be suspected by the presence of gross blood on digital rectal examination. However, this classic sign is not always present on physical examination. If an Antero-Posterior Compression type pelvic fracture is seen, we should consider the possibility of rectal and lower urinary tract injury. It is important to define the anatomic location of the rectal injury as it relates to the peritoneal reflection. Trauma to the intraperitoneal rectum should be managed as a colonic injury. Extraperitoneal rectal injury should be managed with fecal diversion regardless of primary repair. We present the case of a 46-year-old man who was referred to our hospital following a major trauma to the pelvis in a pedestrian accident.
Key Words: Rectal injury; Extra-peritoneal; Pelvic fracture


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