Penetrating Bladder Trauma: A High Risk Factor for Associated Rectal Injury
Demographics and mechanisms were analyzed in prospectively maintained level one trauma center database 1990–2012. Among 2,693 trauma laparotomies, 113 (4.1%) presented bladder lesions; 51.3% with penetrating injuries (n=58); 41.3% (n=24) with rectal injuries, males corresponding to 95.8%, mean age 2...
Saved in:
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2014-01-01
|
| Series: | Advances in Urology |
| Online Access: | http://dx.doi.org/10.1155/2014/386280 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849409487647014912 |
|---|---|
| author | B. M. Pereira L. O. Reis T. R. Calderan C. C. de Campos G. P. Fraga |
| author_facet | B. M. Pereira L. O. Reis T. R. Calderan C. C. de Campos G. P. Fraga |
| author_sort | B. M. Pereira |
| collection | DOAJ |
| description | Demographics and mechanisms were analyzed in prospectively maintained level one trauma center database 1990–2012. Among 2,693 trauma laparotomies, 113 (4.1%) presented bladder lesions; 51.3% with penetrating injuries (n=58); 41.3% (n=24) with rectal injuries, males corresponding to 95.8%, mean age 29.8 years; 79.1% with gunshot wounds and 20.9% with impalement; 91.6% arriving the emergence room awake (Glasgow 14-15), hemodynamically stable (average systolic blood pressure 119.5 mmHg); 95.8% with macroscopic hematuria; and 100% with penetrating stigmata. Physical exam was not sensitive for rectal injuries, showing only 25% positivity in patients. While 60% of intraperitoneal bladder injuries were surgically repaired, extraperitoneal ones were mainly repaired using Foley catheter alone (87.6%). Rectal injuries, intraperitoneal in 66.6% of the cases and AAST-OIS grade II in 45.8%, were treated with primary suture plus protective colostomy; 8.3% were sigmoid injuries, and 70.8% of all injuries had a minimum stool spillage. Mean injury severity score was 19; mean length of stay 10 days; 20% of complications with no death. Concomitant rectal injuries were not a determinant prognosis factor. Penetrating bladder injuries are highly associated with rectal injuries (41.3%). Heme-negative rectal examination should not preclude proctoscopy and eventually rectal surgical exploration (only 25% sensitivity). |
| format | Article |
| id | doaj-art-7cd2a575d7244945aaa21028642e2dd4 |
| institution | Kabale University |
| issn | 1687-6369 1687-6377 |
| language | English |
| publishDate | 2014-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Advances in Urology |
| spelling | doaj-art-7cd2a575d7244945aaa21028642e2dd42025-08-20T03:35:28ZengWileyAdvances in Urology1687-63691687-63772014-01-01201410.1155/2014/386280386280Penetrating Bladder Trauma: A High Risk Factor for Associated Rectal InjuryB. M. Pereira0L. O. Reis1T. R. Calderan2C. C. de Campos3G. P. Fraga4Division of Trauma Surgery, Faculty of Medical Sciences, University of Campinas (UNICAMP), 13083-887 Campinas, SP, BrazilDivision of Urology, Faculty of Medical Sciences, University of Campinas (UNICAMP), Rua Tessália Vieira de Camargo 126, Cidade Universitária “Zeferino Vaz,” 13083-887 Campinas, SP, BrazilDivision of Trauma Surgery, Faculty of Medical Sciences, University of Campinas (UNICAMP), 13083-887 Campinas, SP, BrazilDepartment of Surgery, Faculty of Medical Sciences, University of Campinas (UNICAMP), 13083-887 Campinas, SP, BrazilDivision of Trauma Surgery, Faculty of Medical Sciences, University of Campinas (UNICAMP), 13083-887 Campinas, SP, BrazilDemographics and mechanisms were analyzed in prospectively maintained level one trauma center database 1990–2012. Among 2,693 trauma laparotomies, 113 (4.1%) presented bladder lesions; 51.3% with penetrating injuries (n=58); 41.3% (n=24) with rectal injuries, males corresponding to 95.8%, mean age 29.8 years; 79.1% with gunshot wounds and 20.9% with impalement; 91.6% arriving the emergence room awake (Glasgow 14-15), hemodynamically stable (average systolic blood pressure 119.5 mmHg); 95.8% with macroscopic hematuria; and 100% with penetrating stigmata. Physical exam was not sensitive for rectal injuries, showing only 25% positivity in patients. While 60% of intraperitoneal bladder injuries were surgically repaired, extraperitoneal ones were mainly repaired using Foley catheter alone (87.6%). Rectal injuries, intraperitoneal in 66.6% of the cases and AAST-OIS grade II in 45.8%, were treated with primary suture plus protective colostomy; 8.3% were sigmoid injuries, and 70.8% of all injuries had a minimum stool spillage. Mean injury severity score was 19; mean length of stay 10 days; 20% of complications with no death. Concomitant rectal injuries were not a determinant prognosis factor. Penetrating bladder injuries are highly associated with rectal injuries (41.3%). Heme-negative rectal examination should not preclude proctoscopy and eventually rectal surgical exploration (only 25% sensitivity).http://dx.doi.org/10.1155/2014/386280 |
| spellingShingle | B. M. Pereira L. O. Reis T. R. Calderan C. C. de Campos G. P. Fraga Penetrating Bladder Trauma: A High Risk Factor for Associated Rectal Injury Advances in Urology |
| title | Penetrating Bladder Trauma: A High Risk Factor for Associated Rectal Injury |
| title_full | Penetrating Bladder Trauma: A High Risk Factor for Associated Rectal Injury |
| title_fullStr | Penetrating Bladder Trauma: A High Risk Factor for Associated Rectal Injury |
| title_full_unstemmed | Penetrating Bladder Trauma: A High Risk Factor for Associated Rectal Injury |
| title_short | Penetrating Bladder Trauma: A High Risk Factor for Associated Rectal Injury |
| title_sort | penetrating bladder trauma a high risk factor for associated rectal injury |
| url | http://dx.doi.org/10.1155/2014/386280 |
| work_keys_str_mv | AT bmpereira penetratingbladdertraumaahighriskfactorforassociatedrectalinjury AT loreis penetratingbladdertraumaahighriskfactorforassociatedrectalinjury AT trcalderan penetratingbladdertraumaahighriskfactorforassociatedrectalinjury AT ccdecampos penetratingbladdertraumaahighriskfactorforassociatedrectalinjury AT gpfraga penetratingbladdertraumaahighriskfactorforassociatedrectalinjury |