Clemens Michael S, Peace Kaitlin M, Yi Fia
Division of Colon and Rectal Surgery, San Antonio Military Medical Center, Sam Houston, Texas.
Clin Colon Rectal Surg. 2018 Jan;31(1):17-23. doi: 10.1055/s-0037-1602182. Epub 2017 Dec 19.
The management of rectal trauma has often been lumped in with colon trauma when, in fact, it is a unique entity. The anatomic nature of the rectum (with its intra- and extraperitoneal segments) lends itself to unique circumstances when it comes to management and treatment. From the four Ds (debridement, drainage, diversion, and distal irrigation), the management of rectal trauma has made some strides in light of the experiences coming out of the recent conflicts overseas as well as some rethinking of dogma. This article will serve to review the anatomy and types of injuries associated with rectal trauma. A treatment algorithm will also be presented based on our current literature review. We will also address controversial points and attempt to give our opinion in an effort to provide an update on an age-old problem.
直肠创伤的管理常常与结肠创伤混为一谈，而实际上它是一个独特的实体。直肠的解剖结构（包括腹膜内和腹膜外部分）在管理和治疗方面会带来独特的情况。从“四D原则”（清创、引流、改道和远端冲洗）来看，鉴于海外近期冲突中的经验以及对一些教条的重新思考，直肠创伤的管理已经取得了一些进展。本文将回顾与直肠创伤相关的解剖结构和损伤类型。还将根据我们当前的文献综述提出一种治疗算法。我们也将讨论有争议的问题，并尝试给出我们的观点，以期对这个由来已久的问题提供最新信息。
