Complex Perineal Trauma with Anorectal Avulsion
Introduction. The objective of this case report is to illustrate a severe perineal impalement injury, associated with anorectal avulsion and hemorrhagic shock. Results. A 32-year-old male patient was referred to our hospital for an impalement perineal trauma, associated with complex pelvic fracture...
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doaj-8f5752ee350f4cba8f9de4391c68eca32020-11-24T23:24:45ZengHindawi LimitedCase Reports in Surgery2090-69002090-69192016-01-01201610.1155/2016/48307124830712Complex Perineal Trauma with Anorectal AvulsionAdelina Maria Cruceru0Ionut Negoi1Sorin Paun2Sorin Hostiuc3Ruxandra Irina Negoi4Mircea Beuran5Emergency Hospital of Bucharest, Bucharest, RomaniaEmergency Hospital of Bucharest, Bucharest, RomaniaEmergency Hospital of Bucharest, Bucharest, RomaniaCarol Davila University of Medicine and Pharmacy, Bucharest, RomaniaCarol Davila University of Medicine and Pharmacy, Bucharest, RomaniaEmergency Hospital of Bucharest, Bucharest, RomaniaIntroduction. The objective of this case report is to illustrate a severe perineal impalement injury, associated with anorectal avulsion and hemorrhagic shock. Results. A 32-year-old male patient was referred to our hospital for an impalement perineal trauma, associated with complex pelvic fracture and massive perineal soft tissue destruction and anorectal avulsion. On arrival, the systolic blood pressure was 85 mm Hg and the hemoglobin was 7.1 g/dL. The patient was transported to the operating room, and perineal lavage, hemostasis, and repacking were performed. After 12 hours in the Intensive Care Unit, the abdominal ultrasonography revealed free peritoneal fluid. We decided emergency laparotomy, and massive hemoperitoneum due to intraperitoneal rupture of pelvic hematoma was confirmed. Pelvic packing controlled the ongoing diffuse bleeding. After 48 hours, the relaparotomy with packs removal and loop sigmoid colostomy was performed. The postoperative course was progressive favorable, with discharge after 70 days and colostomy closure after four months, with no long-term complications. Conclusions. Severe perineal injuries are associated with significant morbidity and mortality. Their management in high volume centers, with experience in colorectal and trauma surgery, allocating significant human and material resources, decreases the early mortality and long-term complications, offering the best quality of life for patients.http://dx.doi.org/10.1155/2016/4830712 |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Adelina Maria Cruceru Ionut Negoi Sorin Paun Sorin Hostiuc Ruxandra Irina Negoi Mircea Beuran |
spellingShingle |
Adelina Maria Cruceru Ionut Negoi Sorin Paun Sorin Hostiuc Ruxandra Irina Negoi Mircea Beuran Complex Perineal Trauma with Anorectal Avulsion Case Reports in Surgery |
author_facet |
Adelina Maria Cruceru Ionut Negoi Sorin Paun Sorin Hostiuc Ruxandra Irina Negoi Mircea Beuran |
author_sort |
Adelina Maria Cruceru |
title |
Complex Perineal Trauma with Anorectal Avulsion |
title_short |
Complex Perineal Trauma with Anorectal Avulsion |
title_full |
Complex Perineal Trauma with Anorectal Avulsion |
title_fullStr |
Complex Perineal Trauma with Anorectal Avulsion |
title_full_unstemmed |
Complex Perineal Trauma with Anorectal Avulsion |
title_sort |
complex perineal trauma with anorectal avulsion |
publisher |
Hindawi Limited |
series |
Case Reports in Surgery |
issn |
2090-6900 2090-6919 |
publishDate |
2016-01-01 |
description |
Introduction. The objective of this case report is to illustrate a severe perineal impalement injury, associated with anorectal avulsion and hemorrhagic shock. Results. A 32-year-old male patient was referred to our hospital for an impalement perineal trauma, associated with complex pelvic fracture and massive perineal soft tissue destruction and anorectal avulsion. On arrival, the systolic blood pressure was 85 mm Hg and the hemoglobin was 7.1 g/dL. The patient was transported to the operating room, and perineal lavage, hemostasis, and repacking were performed. After 12 hours in the Intensive Care Unit, the abdominal ultrasonography revealed free peritoneal fluid. We decided emergency laparotomy, and massive hemoperitoneum due to intraperitoneal rupture of pelvic hematoma was confirmed. Pelvic packing controlled the ongoing diffuse bleeding. After 48 hours, the relaparotomy with packs removal and loop sigmoid colostomy was performed. The postoperative course was progressive favorable, with discharge after 70 days and colostomy closure after four months, with no long-term complications. Conclusions. Severe perineal injuries are associated with significant morbidity and mortality. Their management in high volume centers, with experience in colorectal and trauma surgery, allocating significant human and material resources, decreases the early mortality and long-term complications, offering the best quality of life for patients. |
url |
http://dx.doi.org/10.1155/2016/4830712 |
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