Perforating rectal injuries.

The symptomatology, diagnosis and treatment of perforating rectal injuries are discussed. An analysis is presented of the data concerning 24 patients with intra- and extraperitoneal penetration of the rectum. Factors that contribute to the continuing high mortality rate of rectal perforation are its rarity, the highly infectious character of faecal contamination of the abdominal cavity or perirectal tissue, and the fact that examination often reveals little or no external trauma. The treatment of choice would appear to be an aggressive approach based on faecal diversion and drainage, supplemented with peroperative irrigation of the injured rectum.