{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,11]],"date-time":"2026-11-11T12:04:14Z","timestamp":1794398654642,"version":"4.9.0"},"reference-count":27,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2007,4,25]],"date-time":"2007-04-25T00:00:00Z","timestamp":1177459200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2007,4,25]],"date-time":"2007-04-25T00:00:00Z","timestamp":1177459200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.springer.com\/tdm"},{"start":{"date-parts":[[2007,4,25]],"date-time":"2007-04-25T00:00:00Z","timestamp":1177459200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.springer.com\/tdm"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2007,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Rectal injuries are associated with significant morbidity and mortality. Controversy persists regarding routine presacral drainage, distal rectal washout (DRW), and primary repair of extraperitoneal rectal injuries. This retrospective review was performed to determine the outcome of rectal injuries in an urban trauma center with a high incidence of penetrating trauma where a non\u2010aggressive surgical approach to these injuries is practiced.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The records of all patients with a full\u2010thickness penetrating rectal injury admitted to the Trauma Center at Groote Schuur Hospital over a 4\u2010year period were reviewed. These were reviewed for demographics, injury mechanism and perioperative management, anatomical site of the rectal injury, associated intra\u2010abdominal injuries and their management. Infectious complications and mortality were noted. Intraperitoneal rectal injuries were primarily repaired, with or without fecal diversion. Extraperitoneal rectal injuries were generally left untouched and a diverting colostomy was done. Presacral drainage and DRW were not routinely performed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Ninety\u2010two patients with 118 rectal injuries [intraperitoneal (7), extraperitoneal (59), combined (26)] were identified. Only two extraperitoneal rectal injuries were repaired. None had presacral drainage. Eighty\u2010six sigmoid loop colostomies were done. Two (2.2%) fistula, one rectocutaneous, and one rectovesical, were recorded. There were nine (9.9%) infectious complications: surgical site infection (4), buttock abscess (1), buttock necrosis (1), pubic ramus osteitis (1), septic arthritis (2). No perirectal sepsis occurred.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Extraperitoneal rectal injuries due to low\u2010velocity trauma can be safely managed by fecal diversion alone.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00268-007-9045-z","type":"journal-article","created":{"date-parts":[[2007,4,24]],"date-time":"2007-04-24T18:38:25Z","timestamp":1177439905000},"page":"1347-1353","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":48,"title":["Civilian Extraperitoneal Rectal Gunshot Wounds: Surgical Management Made Simpler"],"prefix":"10.1002","volume":"31","author":[{"given":"Pradeep H.","family":"Navsaria","sequence":"first","affiliation":[{"name":"Trauma Center Trauma Unit \u2013 C14 Groote Schuur Hospital, and Faculty of Health Sciences University of Cape Town 7925 Cape Town South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sorin","family":"Edu","sequence":"additional","affiliation":[{"name":"Trauma Center Trauma Unit \u2013 C14 Groote Schuur Hospital, and Faculty of Health Sciences University of Cape Town 7925 Cape Town South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew J.","family":"Nicol","sequence":"additional","affiliation":[{"name":"Trauma Center Trauma Unit \u2013 C14 Groote Schuur Hospital, and Faculty of Health Sciences University of Cape Town 7925 Cape Town South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2007,4,25]]},"reference":[{"key":"e_1_2_5_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0039-6109(16)44688-8"},{"key":"e_1_2_5_3_2","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.1800041608"},{"key":"e_1_2_5_4_2","first-page":"225","article-title":"Abdominal wounds in the Western Desert","volume":"78","author":"Ogilvie WH","year":"1944","journal-title":"Surg Gynecol Obstet"},{"key":"e_1_2_5_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/0002\u20109610(71)90322\u20109"},{"key":"e_1_2_5_6_2","first-page":"1136","article-title":"Rectal trauma: management based on anatomic distinctions","volume":"12","author":"McGrath V","year":"1998","journal-title":"Am Surg"},{"key":"e_1_2_5_7_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.ta.0000205808.46504.e9"},{"key":"e_1_2_5_8_2","doi-asserted-by":"publisher","DOI":"10.1097\/00005373-200109000-00018"},{"key":"e_1_2_5_9_2","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.4468"},{"key":"e_1_2_5_10_2","first-page":"50","article-title":"Management options in penetrating rectal injuries","volume":"57","author":"Ivatury RR","year":"1991","journal-title":"Am Surg"},{"key":"e_1_2_5_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/0002\u20109610(84)90442\u20102"},{"key":"e_1_2_5_12_2","first-page":"37","article-title":"Rectal gunshot wounds: management of civilian wounds","volume":"52","author":"Mangiante EC","year":"1986","journal-title":"Surgery"},{"key":"e_1_2_5_13_2","doi-asserted-by":"publisher","DOI":"10.1097\/00000658-198905000-00013"},{"key":"e_1_2_5_14_2","doi-asserted-by":"publisher","DOI":"10.1007\/s002689910021"},{"key":"e_1_2_5_15_2","doi-asserted-by":"publisher","DOI":"10.1097\/00005373-199502000-00025"},{"key":"e_1_2_5_16_2","first-page":"17","article-title":"Civilian injuries of the rectum and anus","volume":"2","author":"Haas PA","year":"1977","journal-title":"Dis Col Rect"},{"key":"e_1_2_5_17_2","first-page":"215","article-title":"Diagnostic and therapeutic aspects of rectal trauma. 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