PURPOSE:To discuss the presentation, management and outcomes of penetrating anorectal injuries at the Bustamante Hospital for Children. METHODS:A retrospective review over an 11-year period (January 2001-December 2011) was undertaken. The data analysed were extracted from patients' case notes which were pulled based on the hospital's admission database. RESULTS:Over the study period a total of 14 children presented with penetrating anorectal injuries. The medical records for one child were missing. The mean age at presentation was 6 years. Impalement by a metal spike was the mechanism of injury in 12 children, with one case of sexual assault. Three of the children had associated urogenital injuries. Ten rectal injuries were extraperitoneal. Five of the 13 cases (38 %) were managed with a colostomy-average time to closure was 6 months. There was one case of perineal wound infection and dehiscence. There was no mortality. CONCLUSION:Selective fecal diversion in the form of a sigmoid loop colostomy is a safe and acceptable management option for children with penetrating anorectal injuries. The perineal wound itself can be closed primarily except in cases of delayed presentation.

译文

目的:探讨布斯塔曼特儿童医院穿透性肛门直肠损伤的表现,治疗和结果。
方法:进行了为期11年(2001年1月至2011年12月)的回顾性审查。分析的数据是从患者的病历中提取的,这些病历是根据医院的住院数据库提取的。
结果:在研究期间,共有14名儿童发生了肛门直肠穿破伤。一个孩子的病历不见了。报告时的平均年龄为6岁。金属刺钉刺穿是12名儿童受伤的机制,其中1例是性侵犯。其中三个孩子患有泌尿生殖系统损伤。十次直肠外伤是腹膜外的。 13例病例中有5例(38%)接受了结肠造口术,平均闭合时间为6个月。有1例会阴部伤口感染和裂开。没有死亡。
结论:乙状结肠结肠造口术的选择性粪便转移是穿透性肛门直肠损伤儿童的一种安全且可接受的治疗选择。会阴伤口本身可以闭合,除非出现延迟。

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