[War injuries of the rectum and perineum]. / Ratne povrede rektuma i perineuma.

The treatment results of 35 wounded with rectal and perineal lesion, treated in the period from 1991 to 1993 were analyzed retrospectively. In military hospitals, 82% of wounded were primarily surgically managed. The majority (65.8%) was with injury of intraperitoneal rectal segment, 10 patients (28.5%) were with the lesion of extraperitoneal segment and 2 patients (5.7%) were with the injury of anal tract and perineum. The injuries were mostly inflected by the bullets of various calibers (42.6%). Multiple or combined injuries were found in 91.6% of wounded with rectal injury and 38.2% of them were managed within 6 hours after injury. Different surgical procedures, most frequently the lesion suture and proximal colostomy (n = 14) were primarily used. Postoperative complications occurred in 10 wounded (28.6%). In 3 wounded it was reintervened by Hartmann's procedure. Mortality rate was 8.5% (n = 3). Anorectal war injuries are the most severe of all the colonic injuries. To our experience and the unique war surgical doctrine in the primary treatment of rectum injury, the most important is to perform terminal colostomy, injury suture (always intraperitoneal, and extraperitoneal if possible, including the sphincter muscles approximation) and presacral drainage.

[Secondary perforation of the colon in a patient with blast injury of the abdomen--case report]. / Sekundarne perforacije debelog creva kod pacijenta sa blast povredom trbuha--prikaz slucaja.

The patient was admitted to the M.M.A. for correction of defects of both hands seven days after injury caused by explosion. Acute abdomen developed on the same day of admission and laparotomy was performed immediately. Perforations of the cecum and distal part of the sigmoid were found. Based on the data about the time and type of injury sustained it has been concluded that secondary perforations of the colon after blast abdominal injury were present.