Rectal damage control: when to do and not to do
Rectal Trauma Extraperitoneal Rectum Injuries Intraperitoneal Hemodynamically Unstable Hemodynamic Instability Damage Control
Article Sidebar
Main Article Content
Rectal trauma is uncommon, but it is usually associated with injuries in adjacent pelvic or abdominal organs. Recent studies have changed the paradigm behind military rectal trauma management, showing better morbidity and mortality. However, damage control techniques in rectal trauma remain controversial. This article aims to present an algorithm for the treatment of rectal trauma in a patient with hemodynamic instability, according to damage control surgery principles. We propose to manage intraperitoneal rectal injuries in the same way as colon injuries. The treatment of extraperitoneal rectum injuries will depend on the percentage of the circumference involved. For injuries involving more than 25% of the circumference, a colostomy is indicated. While injuries involving less than 25% of the circumference can be managed through a conservative approach or primary repair. In rectal trauma, knowing when to do or not to do it makes the difference.
Luis Saldarriaga, Division of Trauma and Acute Care Surgery, Department of Surgery. Universidad del Valle, Cali, Colombia. Division of Trauma and Acute Care Surgery, Department of Surgery. Hospital Universitario del Valle, Cali, Colombia.
https://orcid.org/0000-0002-7955-8466
Helmer Emilio Palacios-Rodríguez, Division of Trauma and Acute Care Surgery, Department of Surgery. Universidad del Valle, Cali, Colombia
https://orcid.org/0000-0002-6684-982X
Luis Fernando Pino, Division of Trauma and Acute Care Surgery, Department of Surgery. Universidad del Valle, Cali, Colombia. Division of Trauma and Acute Care Surgery, Department of Surgery. Hospital Universitario del Valle, Cali, Colombia.
https://orcid.org/0000-0002-1179-2854
Adolfo González-Hadad, Division of Trauma and Acute Care Surgery, Department of Surgery. Universidad del Valle, Cali, Colombia. Division of Trauma and Acute Care Surgery, Department of Surgery. Hospital Universitario del Valle, Cali, Colombia. Centro Médico Imbanaco, Cali, Colombia
https://orcid.org/0000-0001-5862-4906
Linda M. Gallego, Universidad Icesi, Cali, Colombia.
https://orcid.org/0000-0001-9081-5016
Jessica Capre, Division of Colorectal Surgery, Department of Surgery, Fundacion Valle del Lili, Cali, Colombia
https://orcid.org/0000-0002-1577-5525
Alberto García, Division of Trauma and Acute Care Surgery, Department of Surgery. Universidad del Valle, Cali, Colombia. Division of Trauma and Acute Care Surgery, Department of Surgery. Fundación Valle del Lili. Cali, Colombia. Universidad Icesi, Cali, Colombia.
Fernando Rodriguez-Holguín, Division of Trauma and Acute Care Surgery, Department of Surgery. Fundación Valle del Lili. Cali, Colombia
https://orcid.org/0000-0002-5326-2317
Alexander Salcedo, Division of Trauma and Acute Care Surgery, Department of Surgery. Universidad del Valle, Cali, Colombia. Centro Médico Imbanaco, Cali, Colombia. Division of Trauma and Acute Care Surgery, Department of Surgery. Fundación Valle del Lili. Cali, Colombia. Universidad Icesi, Cali, Colombia
https://orcid.org/0000-0001-8187-0638
Jose Julian Serna, Division of Trauma and Acute Care Surgery, Department of Surgery. Universidad del Valle, Cali, Colombia. Centro Médico Imbanaco, Cali, Colombia. Division of Trauma and Acute Care Surgery, Department of Surgery. Fundación Valle del Lili. Cali, Colombia. Universidad Icesi, Cali, Colombia
https://orcid.org/0000-0001-9829-8930
Mario Alain Herrera, Division of Trauma and Acute Care Surgery, Department of Surgery. Universidad del Valle, Cali, Colombia. Division of Trauma and Acute Care Surgery, Department of Surgery. Hospital Universitario del Valle, Cali, Colombia.
Michael Parra, Department of Trauma Critical Care, Broward General Level I Trauma Center, Fort Lauderdale, FL – USA
https://orcid.org/0000-0001-6496-6275
Carlos Alberto Ordoñez, Division of Trauma and Acute Care Surgery, Department of Surgery. Universidad del Valle, Cali, Colombia. Division of Trauma and Acute Care Surgery, Department of Surgery. Fundación Valle del Lili. Cali, Colombia. Universidad Icesi, Cali, Colombia.
Abraham Kestenberg-Himelfarb, Division of Colorectal Surgery, Department of Surgery, Fundacion Valle del Lili, Cali, Colombia
https://orcid.org/0000-0002-6163-4651
Saldarriaga, L., Palacios-Rodríguez, H. E., Pino, L. F., González-Hadad, A., Gallego, L. M., Capre, J., García, A., Rodriguez-Holguín, F., Salcedo, A., Serna, J. J., Herrera, M. A., Parra, M., Ordoñez, C. A., & Kestenberg-Himelfarb, A. (2021). Rectal damage control: when to do and not to do. Colombia Medica, 52(2), e4124776. https://doi.org/10.25100/cm.v52i2.4776
Downloads
Download data is not yet available.
- Mauricio Millan, Carlos Alberto Ordoñez, Michael Parra, Yaset Caicedo, Natalia Padilla, Luis Fernando Pino, Fernando Rodriguez-Holguín, Alexander Salcedo, Alberto Garcia, Jose Julian Serna, Mario Alain Herrera, Laureano Quintero, Fabián Hernández, Carlos Serna, Adolfo Gonzalez, Hemodynamically unstable non-compressible penetrating torso trauma: a practical surgical approach , Colombia Medica: Vol. 52 No. 2 (2021): Damage Control Surgery (II)
- Carlos Alberto Ordoñez, Michael Parra, Alfonso Holguín, Carlos Garcia, Monica Guzmán-Rodríguez, Natalia Padilla, Yaset Caicedo, Claudia Patricia Orlas, Alberto Garcia, Fernando Rodríguez-Holguín, Jose Julian Serna, Whole-body computed tomography is safe, effective and efficient in the severely injured hemodynamically unstable trauma patient , Colombia Medica: Vol. 51 No. 4 (2020): Damage Control Surgery (I)
- Mario Alain Herrera, Mauricio Millan, Ana Milena del Valle, Mateo Betancourt-Cajiao, Yaset Caicedo, Isabella Caicedo, Linda M. Gallego, Diego Rivera, Michael W Parra, Carlos Alberto Ordoñez, Damage control of peripheral vascular trauma - Don’t be afraid of axillary or popliteal fosses , Colombia Medica: Vol. 52 No. 2 (2021): Damage Control Surgery (II)
- Carlos Alberto Ordoñez, Michael Parra, Yaset Caicedo, Natalia Padilla, Edison Angamarca, Jose Julian Serna, Fernando Rodriguez, Alberto Garcia, Alexander Salcedo, Luis Fernando Pino, Adolfo Gonzalez Hadad, Mario Alain Herrera, Laureano Quintero, Fabian Hernandez, Maria Josefa Franco, Gonzalo Aristizabal, Luis Eduardo Toro, Monica Guzman, Federico Coccolini, Ricardo Ferrada, Rao Ivatury, Damage control surgical management of combined small and large bowel injuries in penetrating trauma: Are ostomies still pertinent? , Colombia Medica: Vol. 52 No. 2 (2021): Damage Control Surgery (II)
- Carlos Serna, José Julian Serna, Yaset Caicedo, Natalia Padilla, Linda M Gallego, Alexander Salcedo, Fernando Rodríguez-Holguín, Adolfo González-Hadad, Alberto Garcia, Mario Alain Herrera, Michael W Parra, Carlos Alberto Ordoñez, Damage control surgery for splenic trauma: "preserve an organ - preserve a life" , Colombia Medica: Vol. 52 No. 2 (2021): Damage Control Surgery (II)
- Alberto Garcia, Mauricio Millan, Daniela Burbano, Carlos Alberto Ordoñez, Michael w Parra, Adolfo González-Hadad, Mario Alain Herrera, Luis Fernando Pino, Fernando Rodríguez-Holguín, Alexander Salcedo, Maria Josefa Franco, Ricardo Ferrada, Juan Carlos Puyana, Damage control in abdominal vascular trauma , Colombia Medica: Vol. 52 No. 2 (2021): Damage Control Surgery (II)
- Carlos Alberto Ordoñez, Michael Parra, Yaset Caicedo, Natalia Padilla, Fernando Rodriguez, Jose Julian Serna, Alexander Salcedo, Alberto Garcia, Claudia Patricia Orlas, Luis Fernando Pino, Ana Milena del Valle, David Alejandro Mejia, Juan Carlos Salamea, Megan Brenner, Tal Hörer, REBOA as a New Damage Control Component in Hemodynamically Unstable Noncompressible Torso Hemorrhage Patients , Colombia Medica: Vol. 51 No. 4 (2020): Damage Control Surgery (I)
- Carlos Alberto Ordoñez, Michael Parra, Mauricio Millan, Yaset Caicedo, Monica Guzman, Natalia Padilla, Juan Carlos Salamea, Alberto Garcia, Adolfo Gonzalez, Luis Fernando Pino, Mario Alain Herrera, Fernando Rodriguez, Jose Julian Serna, Alexander Salcedo, Gonzalo Aristizabal, Claudia Patricia Orlas, Ricardo Ferrada, Thomas Scalea, Rao Ivatury, Damage Control in Penetrating Liver Trauma: Fear of the Unknown , Colombia Medica: Vol. 51 No. 4 (2020): Damage Control Surgery (I)
- Alexander Salcedo, Carlos Alberto Ordoñez, Michael W Parra, José Daniel Osorio, Mónica Guzmán-Rodríguez, Luis Fernando Pino, Mario Alain Herrera, Adolfo González-Hadad, José Julian Serna, Alberto Garcia, Federico Coccolini, Fausto Catena, Damage control for renal trauma: the more conservative the surgeon, better for the kidney , Colombia Medica: Vol. 52 No. 2 (2021): Damage Control Surgery (II)
- Helmer Emilio Palacios-Rodríguez, Nao Hiroe, Mónica Guzmán-Rodríguez, Yaset Caicedo, Luis Saldarriaga, Carlos Alberto Ordoñez, Tomohiro Funabiki, Hybrid trauma service: on the leading edge of damage control , Colombia Medica: Vol. 52 No. 2 (2021): Damage Control Surgery (II)
The copy rights of the articles published in Colombia Médica belong to the Universidad del Valle. The contents of the articles that appear in the Journal are exclusively the responsibility of the authors and do not necessarily reflect the opinions of the Editorial Committee of the Journal. It is allowed to reproduce the material published in Colombia Médica without prior authorization for non-commercial use