[Personal experience with unconventional treatment in extraperitoneal injuries of the rectum]. 2003

Harun Drljević, and Ferid Featahagić
Kantonalna bolnica Zenica, Sluzba za hirurske bolesti.

Because of the unannounced war state in Bosnia and Herzegovina in the period 1992-1995, there were overlapping of war and peaceful doctrine of taking care of all injuries. Many extraperitoneal and intraperitoneal injuries of colon and rectum were treated in the Cantonal Hospital Zenica and in the other war hospitals where the staff of Cantonal Hospital Zenica worked. According to the war doctrine all injuries of colon and rectum are treated operatively with obligatory making colostoma. This presentation includes 7 cases of extraperitoneal rectum injuries from great number of intra- end extraperitoneal injuries of rectum and injuries of colon, which were not treated by principles of war doctrine. We emphasize that surgical teams were experienced, had diagnostic equipment and operation hall with staff and equipment in the case of reintervention. OBJECTIVE Of this presentation is to point out the size of lesion and the association with the other injuries in order to decide about operative or conservative way of treatment as alternative method. It was necessary to define the patients in which we would avoid colostoma with adequate drainage procedures, first of all looking at the size of lesion and the association with the other injuries. Was rectoscopic verification of all 7 injuries with the presentation of size of lesion. Was high grade quality, continuous and adequate toilette and drainage of canal of injury and perirectal area following with antibiotics (metronidasol) and stool regulation. In comparison with doctrinal treatment by making colostoma there was no significant more complications and lethal outcome by this alternative method of treatment. CONCLUSIONS Six of seven cases of extraperitoneal rectum injuries with lesion not bigger than 30 mm and with small pelvis mutilation were solved using conservative method (not making colostoma).

UI MeSH Term Description Entries
D008297 Male Males
D012007 Rectum The distal segment of the LARGE INTESTINE, between the SIGMOID COLON and the ANAL CANAL. Rectums
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D014857 Warfare Methods of conducting ARMED CONFLICTS.
D014947 Wounds and Injuries Damage inflicted on the body as the direct or indirect result of an external force, with or without disruption of structural continuity. Injuries,Physical Trauma,Trauma,Injuries and Wounds,Injuries, Wounds,Research-Related Injuries,Wounds,Wounds and Injury,Wounds, Injury,Injury,Injury and Wounds,Injury, Research-Related,Physical Traumas,Research Related Injuries,Research-Related Injury,Trauma, Physical,Traumas,Wound
D017522 Bosnia and Herzegovina A country of eastern Europe, formerly the province of Bosnia in Yugoslavia, uniting with the province of Herzegovina to form the Republic of Bosnia and Herzegovina in 1946. It was created 7 April 1992 as a result of the division of Yugoslavia and recognized by the United States as an independent state. Bosnia takes is name from the river Bosna, in turn from the Indoeuropean root bhog, "current"; Herzegovina is from the Serbian herceg (duke) + -ov (the possessive) + -ina (country or territory). Bosnia and Hercegovina,Bosnia-Herzegovina,Bosnia

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