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Centro de Investigaciones Regionales Dr. Hideyo Noguchi, Universidad Autónoma de Yucatán

2021, Number 2

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Rev Biomed 2021; 32 (2)

Frequency of trauma by a Foreign body in rectum. Experience of 20 Years at the Hospital civil of Guadalajara

Bravo-Cuellar L, Medina-Padilla LA, Delgado-Sandoval C, Martini-Corona ED, Carrillo-Padilla C, Preciado-Hernández FS, Betancourt-Vicencio S, Bravo-Hernández A, Bravo-Cuellar A

Language: English
References: 19
Page: 69-77
PDF size: 560.39 Kb.


ABSTRACT

Introduction. The insertion of foreign bodies into the rectum is a frequent practice which could lead to proctological emergencies. The practice is not an emergency per se but could precipitate emergencies.
Objective. This paper aims to present more than two decades of experience related to the management of rectal foreign body injuries at the Thoraco-Abdominal Trauma Surgery Service of Civil Hospital Fray Antonio Alcalde of Guadalajara, Jalisco, México.
Materials and Methods. A cross sectional study on a period of 20 years (1999-2018) was carried out based on the data recorded in the hospital’s archives and included patients of both sexes with an age range between 15 and 91 years.
Results. There was a total of 194 patients (169 males and 25 females) with 75 cases (38 %) ranging between 30 and 44 years old. The incidence of foreign body induced rectal injuries was 4.0 ± 2.1 patients per year, between 1999 and 2018 and 15.4 ± 8.8 cases per year between 2011-2018. Proctorrhagia was the predominant sign (56 patients), followed by foreignbody sensation (49 patients) and abdominal pain (41 patients). Diagnosis was based mainly on digital rectal examination (100 %) and plain abdominal x-ray (94 %). Manual extraction was performed in 82 % of the cases, laparotomy in 10 cases (5 %) and colonoscopy in 5 cases (2.5 %). The main complications were mucosal tears in 50 cases (57 %), skin and mucosa tears in 12 cases (14 %), and perforation in 8 cases (9 %).
Conclusions. The frequency of foreign body related rectal injuries is increasing over the past years posing a real challenge for the surgeons due to the various complications and the distinct nature of their management and surgical repair. The on call surgeons must be familiarized with various treatment approaches form manual extraction, to endoscopic extraction, laparotomies and stoma formation. The complex nature of the surgical management and an increasing incidence of these injuries prompted the authors to share their experience on this topic.


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