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.
- Michael W Parra, Carlos Alberto Ordoñez, David Mejia, Yaset Caicedo, Javier Mauricio Lobato, Oscar Javier Castro, Juan Alfonso Uribe, Fernando Velasquez, Damage control approach to refractory neurogenic shock: a new proposal to a well-established algorithm , Colombia Medica: Vol. 52 No. 2 (2021): Damage Control Surgery (II)
- 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)
- 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)
- 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)
- Michael Parra, Carlos Alberto Ordoñez, Luis Fernando Pino, Mauricio Millan, Yaset Caicedo, Victor Rafael Bucheli, Alberto Garcia, Adolfo Gonzalez-Hadad, Alexander Salcedo, Jose Julian Serna, Laureano Quintero, Mario Alain Herrera, Fabian Hernandez, Fernando Rodriguez, Damage Control Surgery for Thoracic Outlet Vascular Injuries: The New Resuscitative Median Sternotomy Plus Endovascular Aortic Balloon Occlusion of the Aorta Approach , Colombia Medica: Vol. 52 No. 2 (2021): Damage Control Surgery (II)
- Mauricio Millan, Michael W Parra, Boris Sanchez-Restrepo, Yaset Caicedo, Carlos Serna, Adolfo González-Hadad, Luis Fernando Pino, Mario Alain Herrera, Fabian Hernandez, Fernando Rodríguez-Holguín, Alexander Salcedo, José Julian Serna, Alberto Garcia, Carlos Alberto Ordoñez, Primary repair: damage control surgery in esophageal trauma , Colombia Medica: Vol. 52 No. 2 (2021): Damage Control Surgery (II)
- Mario Alain Herrera, Luis Fernando Tintinago, William Victoria, Carlos Alberto Ordoñez, Michael Parra, Mateo Betancourt-Cajiao, Yaset Caicedo, Monica Guzman, Linda M. Gallego, Adolfo Gonzalez Hadad, Luis Fernando Pino, Jose Julian Serna, Alberto García, Carlos Serna, Fabian Hernandez, Damage Control of Laryngotracheal Trauma: The Golden Day , Colombia Medica: Vol. 51 No. 4 (2020): Damage Control Surgery (I)
- Monica Vargas, Alberto Garcia, Yaset Caicedo, Michael Parra, Carlos Alberto Ordoñez, Damage control in the intensive care unit: what should the intensive care physician know and do? , Colombia Medica: Vol. 52 No. 2 (2021): Damage Control Surgery (II)
- Carlos Alberto Ordoñez, Yaset Caicedo, Michael W Parra, Fernando Rodríguez-Holguín, José Julian Serna, Alexander Salcedo, Maria Josefa Franco, Luis Eduardo Toro, Luis Fernando Pino, Monica Guzmán-Rodríguez, Claudia Orlas, Juan Pablo Herrera-Escobar, Adolfo González-Hadad, Mario Alain Herrera, Gonzalo Aristizabal, Alberto Garcia, Evolution of damage control surgery in non-traumatic abdominal pathology: a light in the darkness , Colombia Medica: Vol. 52 No. 2 (2021): Damage Control Surgery (II)
- Carlos Alberto Ordoñez, Mónica Morales, Johanna Carolina Rojas-Mirquez, Francisco Javier Bonilla-Escobar, Marisol Badiel, Fernando Miñán Arana, Adolfo González, Luis Fernando Pino, Amadeus Uribe-Gómez, Mario Alain Herrera, Maria Isabel Gutiérrez-Martínez, Juan Carlos Puyana, Michael Abutanos, Rao R. Ivatury, Trauma Registry of the Pan American Society of Trauma: One year of experience in two referral centers in the colombian southwestern , Colombia Medica: Vol. 47 No. 3 (2016)
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