Citation

Joos AK, Herold A, Palma P, Post S. Chirurg 2006; 77(9): 781-789.

Vernacular Title

Pfahlungsverletzungen des Anus und des Rektums.

Affiliation

Chirurgische Universitätsklinik Mannheim, Klinikum Mannheim gGmbH, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim.

Copyright

(Copyright © 2006, Holtzbrinck Springer Nature Publishing Group)

DOI

10.1007/s00104-006-1220-5

PMID

16896899

Abstract

Perianal impalement injuries with or without involvement of the anorectum are rare. Apart from a high variety of injury patterns, there is a multiplicity of diagnostic and therapeutic options. Causes of perianal impalement injury are gunshot, accidents, and medical treatment. The diagnostic work-up includes digital rectal examination followed by rectoscopy and flexible endoscopy under anaesthesia. We propose a new classification for primary extraperitoneal perianal impalement injuries in four stages in which the extension of sphincter and/or rectum injury is of crucial importance. Therapeutic aspects such as wound treatment, enterostomy, drains, and antibiotic treatment are discussed. The proposed classification encompasses recommendations for stage-adapted management and prognosis of these rare injuries.

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