@article{ref1,
title="The management of penetrating rectal and anal trauma: a systematic review",
journal="Injury",
year="2017",
author="Ahern, Daniel P. and Kelly, Michael E. and Courtney, Danielle and Rausa, Emanuele and Winter, Des C.",
volume="48",
number="6",
pages="1133-1138",
abstract="INTRODUCTION: Traumatic injuries to the lower gastrointestinal tract (rectum and anus) have been largely reported in the military setting with sparse publications from the civilian setting. Additionally, there remains a lack of international consensus regarding definitive treatment pathways. This systematic review aimed to assess the current literature and propose a standardised treatment algorithm to aid management in the civilian setting. <br><br>METHODS: A systematic review of available literature from 1999 to 2016 that was performed. Primary endpoints were the assessment and surgical management of reported rectal and anal trauma. <br><br>RESULTS: Seven studies were included in this review, reporting on 1255 patients. 96.3% had rectal trauma and 3.7% had anal trauma. Gunshot wounds are the most common mechanism of injury (46.9%). The overwhelming majority of injuries occurred in males (>85%) and were associated with other pelvic injuries. Surgical management has substantially evolved over the last five decades, with no clear consensus on best management strategies. <br><br>CONCLUSION: There remains significant international discrepancy regarding the management of penetrating trauma to the rectum. Key management principals include the varying use of the direct primary closure, faecal diversion, pre-sacral drainage and/or distal rectal washout (rarely used). To date, there is sparse evidence regarding the management of penetrating anal trauma.<br><br>Copyright © 2017. Published by Elsevier Ltd.<p /> <p>Language: en</p>",
language="en",
issn="0020-1383",
doi="10.1016/j.injury.2017.03.002",
url="http://dx.doi.org/10.1016/j.injury.2017.03.002"
}