DOI QR코드

DOI QR Code

Diagnostic Laparoscopy and Laparoscopic Diverting Sigmoid Loop Colostomy in Penetrating Extraperitoneal Rectal Injury: A Case Report

  • Jo, Young Goun (Division of Trauma Surgery, Department of Surgery, Chonnam National University Hospital) ;
  • Park, Yun Chul (Division of Trauma Surgery, Department of Surgery, Chonnam National University Hospital) ;
  • Kang, Wu Seong (Division of Trauma Surgery, Department of Surgery, Chonnam National University Hospital) ;
  • Kim, Jung Chul (Division of Trauma Surgery, Department of Surgery, Chonnam National University Hospital) ;
  • Park, Chan Yong (Trauma Center, Pusan National University Hospital)
  • Received : 2017.11.13
  • Accepted : 2017.12.09
  • Published : 2017.12.30

Abstract

Laparoscopy has been one of the most effective modalities in various surgical situations, although its use in trauma patients has some limitations. The benefits of laparoscopy include cost-effectiveness, shorter length of hospital stay, and less postoperative pain. This report describes diagnostic laparoscopy and laparoscopic diverting sigmoid loop colostomy in penetrating extraperitoneal rectal injury. A 41-year-old male presented with perineal pain following penetrating trauma caused by a tree limb. Computed tomography showed air density in the perirectal space and retroperitoneum. As his vital signs were stable, we performed diagnostic laparoscopy and confirmed no intraperitoneal perforation. Therefore, laparoscopic diverting sigmoid loop colostomy was performed. He was discharged without any complications despite underlying hepatitis C-related cirrhosis. Colostomy closure was performed 3 months later.

Keywords

References

  1. Sauerland S, Agresta F, Bergamaschi R, Borzellino G, Budzynski A, Champault G, et al. Laparoscopy for abdominal emergencies: evidence-based guidelines of the European Association for Endoscopic Surgery. Surg Endosc 2006;20:14-29. https://doi.org/10.1007/s00464-005-0564-0
  2. Zantut LF, Ivatury RR, Smith RS, Kawahara NT, Porter JM, Fry WR, et al. Diagnostic and therapeutic laparoscopy for penetrating abdominal trauma: a multicenter experience. J Trauma 1997;42:825-9; discussion 829-31. https://doi.org/10.1097/00005373-199705000-00012
  3. Velmahos GC, Gomez H, Falabella A, Demetriades D. Operative management of civilian rectal gunshot wounds: simpler is better. World J Surg 2000;24:114-8. https://doi.org/10.1007/s002689910021
  4. Navsaria PH, Shaw JM, Zellweger R, Nicol AJ, Kahn D. Diagnostic laparoscopy and diverting sigmoid loop colostomy in the management of civilian extraperitoneal rectal gunshot injuries. Br J Surg 2004;91:460-4. https://doi.org/10.1002/bjs.4468
  5. Navsaria PH, Graham R, Nicol A. A new approach to extraperitoneal rectal injuries: laparoscopy and diverting loop sigmoid colostomy. J Trauma 2001;51:532-5.
  6. Sosa JL, Arrillaga A, Puente I, Sleeman D, Ginzburg E, Martin L. Laparoscopy in 121 consecutive patients with abdominal gunshot wounds. J Trauma 1995;39:501-4; discussion 504-6.
  7. Zafar SN, Onwugbufor MT, Hughes K, Greene WR, Cornwell EE 3rd, Fullum TM, et al. Laparoscopic surgery for trauma: the realm of therapeutic management. Am J Surg 2015;209:627-32. https://doi.org/10.1016/j.amjsurg.2014.12.011
  8. Mattox KL, Moore EE, Feliciano DV. Trauma. 7th ed. New York: McGraw Hill; 2013.
  9. Trejo-Avila ME., Valenzuela-Salazar C, Betancourt-Ferreyra J, Fernandez-Enriquez E, Romero-Loera S, Moreno-Portillo M. Laparoscopic versus open surgery for abdominal trauma: a case-matched study. J Laparoendosc Adv Surg Tech A 2017;27:383-7. https://doi.org/10.1089/lap.2016.0535
  10. Parks SE, Hastings PR. Complications of colostomy closure. Am J Surg 1985;149:672-5. https://doi.org/10.1016/S0002-9610(85)80153-7
  11. Renz BM, Feliciano DV, Sherman R. Same admission colostomy closure (SACC). A new approach to rectal wounds: a prospective study. Ann Surg 1993;218:279-92; discussion 292-3. https://doi.org/10.1097/00000658-199309000-00007
  12. Khalid MS, Moeen S, Khan AW, Arshad R, Khan AF. Same admission colostomy closure: a prospective, randomised study in selected patient groups. Surgeon 2005;3:11-4. https://doi.org/10.1016/S1479-666X(05)80004-6
  13. Velmahos GC, Degiannis E, Wells M, Souter I, Saadia R. Early closure of colostomies in trauma patients--a prospective randomized trial. Surgery 1995;118:815-20. https://doi.org/10.1016/S0039-6060(05)80270-3