Presentation
The object of this report is to present our experience of prenatal extraperitoneal rectal perforation, defining the clinical presentation, management, and progress. [ncbi.nlm.nih.gov]
If it goes anteriorly it can present as rectourethral fistula 10. If it goes posteriorly, it may present in the form of a neuroenteric fistula or sinus 11. [journals.lww.com]
Entire Body System
- Wound Infection
No fistulae or wound infections occurred, but closure of 1 colostomy was complicated. [ncbi.nlm.nih.gov]
The main complication after penetrating perineal injuries is wound infection with abscess formation and subsequently sepsis. This is why fecal diversion still stays as a mainstay of management [4,5]. [journals.lww.com]
The review found high-quality evidence, showing that prophylaxis with antibiotics covering aerobic and anaerobic bacteria prior to elective colorectal surgery reduces the risk of surgical wound infection. [wjes.biomedcentral.com]
- Acutely Ill Patient
The literature shows that bedside abdominal US has a higher sensitivity and same specificity with abdominal plain X-ray; moreover, it allows environmental stress reduction to an acutely ill patient [30]. [wjes.biomedcentral.com]
- Perineal Swelling
It typically presents in neonates with a gas-filled or meconium-filled perineal or buttock swelling, leading to a risk of skin rupture, intraperitoneal perforation, and systemic sepsis 2. [journals.lww.com]
- Neonatal Intestinal Obstruction
The impact of cystic fibrosis on neonatal intestinal obstruction: the need for prenatal/neonatal screening. Pediat Surg Int 2003; 19: 75–78. 6 Schlensker KH, Gunther H, Bolte A. [nature.com]
- Splenectomy
The internal bleeding was managed successfully without splenectomy. Four weeks later a contrast enema indicated a normal rectum without stricture so intestinal continuity was restored. [nature.com]
Respiratoric
- Respiratory Distress
Consciousness change and respiratory distress developed 6 hours later. She was then transferred to a trauma center where extraperitoneal rectal perforation was diagnosed. [ncbi.nlm.nih.gov]
The various clinical symptoms include dysphagia, odynophagia, chest pain, respiratory distress, hematemesis, GI bleeding, acute abdominal pain, intestinal perforation, bowel obstruction, localized abscess formation, peritonitis, inflammatory masses or [wjgnet.com]
Gastrointestinal
- Acute Abdomen
In this report, we present a case of child physical abuse resulting in bladder and rectal perforations, which was initially referred to our hospital as acute abdomen with intraperitoneal free fluid on ultrasonography. [ncbi.nlm.nih.gov]
J Pioneer Med Sci. 2014; 4(1):49-51 Case Report ABSTRACT Spontaneous perforation of the colon or rectum is a rare cause of acute abdomen in surgery. [jpmsonline.com]
abdomen in surgical practice. [nepjol.info]
Physical examination showed signs of acute abdomen and fresh blood on digital rectal examination. Pneumoperitoneum was detected on an erect plain abdominal radiograph (Fig. 1). Fig. 1: Radiograph showing subdiaphragmatic free air. [journals.lww.com]
Image from CT scan of abdomen In this context, the diagnosis of acute abdomen was made and she underwent to surgical intervention. Exploratory laparotomy revealed fluid in the peritoneal cavity and barium leakage into the pelvic cavity. [onlinelibrary.wiley.com]
Cardiovascular
- Tachycardia
On examination at our centre, about 3 h after his fall, he had tachycardia but was haemodynamically stable. Abdomen examination revealed tenderness in the lower abdomen with no peritoneal signs. There were no bruises or evidence of pelvic fracture. [journalofmas.com]
She was in septic shock with tachycardia, tachypnea, and hypotension. [surgicalcasereports.springeropen.com]
In this setting, physical examination reveals an acutely ill patient characterised by fever, tachypnea, tachycardia and confusion. The abdomen may be diffusely tender or may present localised tenderness, guarding, or rebound tenderness. [wjes.biomedcentral.com]
Skin
- Palpable Purpura
In addition to palpable purpura, arthritis or arthralgia, renal disease and abdominal pain, gastrointestinal symptoms occur in 50% of children. [ncbi.nlm.nih.gov]
- Purpura
In addition to palpable purpura, arthritis or arthralgia, renal disease and abdominal pain, gastrointestinal symptoms occur in 50% of children. [ncbi.nlm.nih.gov]
Article Sidebar Published: Sep 21, 2017 Case Reports Keywords Henoch-Schönlein purpura, Bowel perforation, Abdominal pain, Rectal perforation. [reumatismo.org]
- Lanugo
Aspirate from the scrotum revealed meconium, vernix, and lanugo. Anal opening was normal. Fecal staining was seen on inserting a 10 Fr infant feeding tube per rectum. Nasogastric aspirate was bilious in nature. [journals.lww.com]
- Skin Discoloration
Both buttocks had fluctuant swellings with skin discoloration (Fig. 1). Systemic examination showed mild abdominal distension with absent bowel sounds. [journals.lww.com]
Urogenital
- Scrotal Mass
Most commonly, it resents as a buttock, perineal, or scrotal mass with or without fistulization 1–9. The buttock mass can be left sided, right sided, or midline posteriorly 1,3,8. [journals.lww.com]
Workup
The barium enema, although present indications are currently restricted, is still useful on radiological workup in the colon. [scielo.br]
The workup should include endoscopy to rule out bowel perforation, vaginoscopy in girls, and cystoscopy or urography to identify urinary tract injury, especially if hematuria is present [3]. [journals.lww.com]
Laboratory workup revealed slightly elevated WBC count. (11.07 × 109/ L). Other laboratory findings were within normal. [clinicsinsurgery.com]
In CRCE, the long-term oncologic outcome can be influenced by an advanced disease and by the higher rate of incomplete preoperative workup. [wjes.biomedcentral.com]
Treatment
The clinical presentation, course of disease and response to treatment supported the concept of CMV as a primary aetiological agent. [ncbi.nlm.nih.gov]
Bowel perforation under antiangiogenic TKI treatment is in most cases of early occurrence, in the first months (up to five months) if not the first weeks of treatment. [em-consulte.com]
The choice of treatment should be determined after considering the state of the patient. Conclusion:- Stapled hemorrhoidectomy is widely used for treatment of pro-lapsed hemorrhoids because of certain advantages. [scribd.com]
The treatments are diversify by suture of the breach to the Hartmann procedure o abdominal peritoneal amputation in the more severe cases.The associate treatment medical ad surgical has permitted (allowed) to reduced the mortality of rectum trauma by [minervamedica.it]
Prognosis
Hence the better prognosis is with early surgical intervention; worst the prognosis with late intervention. Birat Journal of Health Sciences 2016 1(1): 87-90 Downloads Download data is not yet available. How to Cite Singh, R. (2017). [nepjol.info]
Discussion Anorectal impalement injuries have favorable prognosis in childhood, being diagnosed early because of the traumatic background of the injury. [journals.lww.com]
Severe GI involvements such as bleeding and perforations have been reported to be major factors of poor prognosis [ 6 ]. [surgicalcasereports.springeropen.com]
Prognosis A GI perforation is a medical emergency and requires quick recognition of the signs and symptoms, and rapid medical response. When this occurs, recovery should be complete. [sepsis.org]
Etiology
As none of the reported causes of intestinal perforation were identified in our case, its etiology remained idiopathic. [ncbi.nlm.nih.gov]
Given that none of the reported causes of prenatal intestinal perforation were identified, the etiology of our case remained idiopathic. [nature.com]
Rectal perforations with evisceration of intestinal content can have multiple etiologies, which are traditionally classified into 2 groups, trauma-related and spontaneous, whose etiologic mechanism is uncertain.2 We present the case of a patient who developed [elsevier.es]
We report the case of male patient, 40 years, two months ago had intense anal pain and bleeding during performing of barium enema for etiologic investigation of constipation, with spontaneous improvement after a month. [scielo.br]
Spontaneous perforation of the rectum with possible stercoral etiology: report of a case and review of the literature. Surg Today. 1998;28:937–939 Keywords: children; foreign body; rectal perforation © 2011 Annals of Pediatric Surgery [journals.lww.com]
Epidemiology
Haggar FA, Boushey RP: Colorectal cancer epidemiology: incidence, mortality, survival, and risk factors. Clin Colon Rectal Surg. 2009; 22 (4): 191–7. PubMed Abstract | Publisher Full Text | Free Full Text 2. [f1000research.com]
Epidemiology There is not enough data in the literature on the incidence and prevalence of rectum or colon perforations. [intechopen.com]
An epidemiologic and clinical study with special reference to incidence and survival. Acta Chir Scand. 1987;153(10):607–14. 12. Gunnarsson H, Holm T, Ekholm A, Olsson LI. Emergency presentation of colon cancer is most frequent during summer. [wjes.biomedcentral.com]
Pathophysiology
Its etiology and pathophysiology are poorly understood. Only 16 cases have been reported worldwide. We report another case of fetal extraperitoneal rectal perforation managed by us. [journals.lww.com]
To bear in mind that the emergency surgeon should have a strong oncologic background or that the specialised colorectal surgeon should have a strong background of surgical pathophysiology, emergency surgery and damage control philosophy. [wjes.biomedcentral.com]
Prevention
Simple measures like wearing protective garments might be enough to prevent them. Complete defunctioning colostomy is better in these cases than partially defunctioning colostomy. [ncbi.nlm.nih.gov]
Pescatori, M, Quondamcarlo, C 1999 Prevention of intraoperative complications during stapled excision of rectal mucosal prolapse Tech Coloproct 3 103 104 Google Scholar 5. [link.springer.com]
In addition to surgery to repair the perforation, you will likely receive intravenous (IV) antibiotics to either prevent an infection from occurring or to treat one that has started. [sepsis.org]
This case report of rectal perforation in a neonate secondary to anal stenosis discusses the associated diagnostic and management complexities in order to prevent future complications. [jpss.eu]