[Traumatic injuries of the rectum and anus in childhood].

Abstract

Objective: To analyze treatment outcomes in children with anorectal injury.

Material and methods: There were 31 children aged 1-18 years with traumatic injuries of the rectum and anus. Diagnostic measures included analysis of anamnesis, examination, rectal examination, bladder catheterization, X-ray methods including CT and MRI.

Results: Over the past 30 years, combined trauma has occurred in 346 children. Of these, 217 children died at the scene, 12 - in hospitals. Injuries of more than 3 areas were observed in 184 children. Injuries of the rectum and anus were diagnosed in 31 children. In 9 children, anorectal injury was the result of traffic accidents. All ones had TBI, thoracoabdominal trauma, bone fractures of extremities and pelvis. Four people died at the scene. In 10 children, anorectal injury was associated with damage by foreign bodies including falling from height (n=2) and sledding (n=2). In one child, damage to the rectum and large intestine was associated with injection of compressed air into the rectum under pressure. Thermal trauma of the perineum with anorectal injury occurred in 3 young children. Two girls younger 6 years old had anorectal injury due to rape. In 6 children, damage to the rectum occurred after pelvic surgery (n=4) and injury of sphincter in patients with rectal atresia (n=2). The author presents 3 own cases.

Conclusion: Traumatic anorectal injuries are severe lesions in childhood. The primary objective in patients with combined trauma and anorectal injury is to save the child's life through diagnosis and treatment of life-threatening syndromes. Diagnosis and treatment should be carried out after exclusion of all probable causes taking into account the need for emergency care. Surgical treatment was favorable in all children.