@article{ref1,
title="Perianal and rectal impalement injuries",
journal="Chirurg: Zeitschrift fur alle Gebiete der Operativen Medizen",
year="2006",
author="Joos, A. K. and Herold, A. and Palma, P. and Post, S.",
volume="77",
number="9",
pages="781-789",
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.<p /><p>Language: de</p>",
language="de",
issn="0009-4722",
doi="10.1007/s00104-006-1220-5",
url="http://dx.doi.org/10.1007/s00104-006-1220-5"
}