Drago G W, Bigliani S, Marino B, Piccoli F, Kiss A, Vitale L
Divisione di Chirurgia Generale, Regione Piemonte, USSL n. 30, Ospedale Maggiore di Chieri, Torino.
Minerva Chir. 1994 Jan-Feb;49(1-2):103-5.
The authors describe a case of intraperitoneal anorectal injury. Such injuries now have an improved survival rate as a result undoubtedly of superior resuscitation, early operative management and early use of antibiotics. Civilian life rectal wounds are usually of the penetrating type. Major complications, both of intra and extraperitoneal injuries, are related to infection. The surgical management of these lesions is primarily a proximal diversion of the fecal stream. This is accomplished by a divided--end colostomy. Local wound care must be given for the inevitable infected foreign tract. When sepsis occurs, the surgeon must be prepared to handle it adequately by appropriate incision and drainage.
作者描述了一例腹膜内肛管损伤的病例。由于复苏手段更优、早期手术治疗以及早期使用抗生素，此类损伤的存活率现已有所提高。平民生活中的直肠伤口通常为穿透性。腹膜内和腹膜外损伤的主要并发症均与感染有关。这些损伤的手术治疗主要是近端粪便转流。这通过端部分离式结肠造口术来完成。对于不可避免的感染性异物通道，必须进行局部伤口护理。当发生脓毒症时，外科医生必须准备好通过适当的切开引流来妥善处理。
