Management of rectal trauma.

A 9 year review of rectal trauma was conducted. Forty-seven patients had major rectal trauma requiring diversion. Twenty-seven percent of patients presented in shock. Routine perioperative antibiotics were administered. Ninety-five percent of patients had positive findings on digital rectal examination or proctoscopy. There were 91 associated injuries. Rectal injuries were repaired in 19 patients. The absence of repair had no influence on postoperative morbidity or length of hospital stay. Ninety-five percent of patients had presacral drainage. One patient had distal rectal irrigation. Both loop and divided colostomies were utilized with no difference in morbidity or hospital stay. There were no deaths. Proctoscopy is essential in patients with wounds in proximity to the rectum. Diversion and presacral drainage for rectal injury is associated with a low mortality and acceptable morbidity. Rectal washout does not appear to be essential in civilian rectal injuries.