Proctosigmoidoscopy Repair as the Primary Management for an Extensive Low Rectal Injury with Extraperitoneal and Intraperitoneal Involvement in a Girl

Penetrating rectal injury is relatively rare in children. Colorectal perforation is presumed a dirty wound in which local drainage and diversion colostomy should be considered in addition to primary repair. Laparotomy or laparoscopy as initial management has been recommended for those with intra-abdominal involvement. We presented a 5-year-old girl who accidentally sat on a long-handle spoon that penetrated into her anus and manifested with massive pneumoperitoneum. She was successfully managed by proctosigmoidoscopic transanal rectal repair with laparoscopic intra-abdominal drainage without a diversion colostomy. To simplify surgical procedures, a proctosigmoidoscope transanal repair is an option for the initial management of pneumoperitoneum-associated rectal impalement.

關鍵字

Rectal impalement ； Proctosigmoidoscopy ； Primary repair

並列摘要

穿透性直腸損傷在兒童中相對少見。結腸直腸穿孔被認為是污染性傷口，除了直接修復外，還應考慮局部引流和結腸造口術。對於合併腹腔內損傷的患者，文獻建議將剖腹探查術或腹腔鏡檢查作為初步治療。我們介紹一個5歲的女孩不小心坐在一個長柄勺子上，勺子穿透了她的肛門，表現了大量氣腹。我們成功地以直腸乙狀結腸鏡經肛門直腸修復術及腹腔鏡腹腔內引流治療，而無需進行結腸改道造口術。選擇先以直腸乙狀結腸鏡經肛門檢查及修復直腸穿刺合併氣腹，可簡化且避免了其他創傷性外科手術治療。

並列關鍵字

直腸穿刺；直腸乙狀結腸鏡檢查

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