RESUMO
Objective To summarize the experience in diagnosis and treatment of rectal injury. Methods The diagnosis and treatment of 40 cases of rectal injury in the recent 6 years were retrospectively analysed. The diagnosis of rectal injury relied on injury history, clinical presentation,anorectal examination , sigmoid coloscopy ,and explorare laparotomy.38 cases treated by surgery ,including rectal repear ,sigmoid colostomy plus drainge ,and resection of injuried segment of rectum.1case treated by non-operation. 1 case died 2h after admittion. Results 39 cases recovered and 1 case died.Conclusions The condition of rectal injury is very complicate.Due attention should be paid to the diagnosis and treatment.
RESUMO
Objective To investigate the diagnosis and management of pancreatic injury. Methods The clinical data of 23 patients suffering from pancreatic injury treated by surgery in recent 15 years were analyzed retrospectively. According to the pancreas organ injury scale of the American Association for the Surgery of Trauma, there were 8 cases in grade I, 8 in grade II, 5 in grade III, 1 in grade IV and 1 in grade V. Results Only 2 patients were diagnosed preoperatively out of the 19 patients.About 63.2%(12/19)of the cases had elevated levels of serum amylase. All the patients were cured.In this series,8 cases occurred external pancreatic fistula, 4 pseudocysts, 2 intra-abdominal infections and 1 hyperglycemia postoperatively. Internal pancreatic fistulas were found in all the non operation patients. Conclusions The serum amylase determinations is neither sensitive nor specific for diagnosis of pancreatic injury. Early diagnosis and correct operative pracedure are important to decrease the postoperative complications and improve the outcome.