Colonic and rectal injuries are usually caused by work and production injuries, traffic accidents, life accidents, and fights in daily life, and abdominal closed injuries are more common. Colonic and rectal injuries generally have a history of abdominal or other nearby external trauma or colonoscopy, and abdominal pain or other discomfort symptoms appear after injury.
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Colonic and rectal injuries
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1. What are the causes of colonic and rectal injuries
2. What complications are easily caused by colonic and rectal injuries
3. What are the typical symptoms of colonic and rectal injuries
4. How to prevent colonic and rectal injuries
5. What laboratory tests are needed for colonic and rectal injuries
6. Diet taboo for patients with colonic and rectal injuries
7. Conventional methods of Western medicine for the treatment of colonic and rectal injuries
1. What are the causes of colonic and rectal injuries
Colonic and rectal injuries are mainly caused by heavy object impact on the abdomen, such as industrial accidents, traffic accidents, falls, falls, fights, boxing, and other blunt force impacts. The large intestine is located between the posterior abdominal wall and the anterior abdominal wall, which causes the intestinal wall to be injured, perforated, or broken. Sigmoidoscopy and fiber colonoscopy examination can cause colonic perforation, which is occasionally seen.
2. What complications are easily caused by colonic and rectal injuries
Colonic and rectal injuries generally have a history of abdominal or other nearby external trauma or colonoscopy, and abdominal pain or other discomfort symptoms appear after injury. Colonic and rectal injuries can complicate with bacterial peritonitis, toxic shock, and retroperitoneal infection. The most common complication after surgical treatment is the leakage of the anastomotic stoma.
3. What are the typical symptoms of colonic and rectal injuries
Colonic and rectal injuries generally have a history of abdominal or other nearby external trauma or colonoscopy, and abdominal pain or other discomfort symptoms appear after injury. The specific clinical manifestations are as follows:
1. Abdominal pain and vomiting Perforation or large-scale damage of the sigmoid colon and rectum, abdominal pain and vomiting occur immediately after feces in the intestinal cavity overflow into the abdominal cavity. The pain is initially localized to the perforation site, followed by spread to the entire abdomen, forming a diffuse peritonitis with pain all over the abdomen.
2. Peritoneal irritation sign Abdominal tenderness, muscle tension, and rebound pain, the most obvious pain is at the perforation or rupture site.
3. Abdominal auscultation Intestinal sounds are weakened or even disappear.
4. Rectal examination Low rectal injuries can be felt as a hollow sensation at the injury site, with bloodstains on the gloves. Colonic injuries have only a few bloodstains.
4. How to prevent colonic and rectal injuries
There is no specific preventive measure for colonic and rectal injuries, attention should be paid to avoid trauma. When abdominal trauma occurs, be vigilant for colonic and rectal injuries, detect early, treat early, and prevent the occurrence of complications.
5. What laboratory tests are needed for colonic and rectal injuries
The diagnosis of colonic and rectal injuries relies not only on symptoms and signs but also on related examinations, which are indispensable. The commonly used examinations in clinical practice are as follows:
1. Blood routine The examination shows an increase in white blood cell count and neutrophils.
2. X-ray For closed injuries, if the patient's condition allows for standing radiographs, most can be found to have free intraperitoneal gas under the diaphragm.
3. Ultrasound, CT, MRI The above examinations cannot make a clear diagnosis, and any one or two of them can be selectively used to assist in diagnosis.
6. Dietary taboos for patients with colonic and rectal injuries
Patients with colonic and rectal injuries should eat soft, easily digestible, and nutritious food, and appropriately supplement a variety of vitamins. It is advisable to avoid spicy and stimulating foods with high fiber content, such as chili, sweet potatoes, celery, and other coarse foods, and also not to eat high-fat foods and fried foods. It is also necessary to avoid stimulating foods and drinks such as alcohol and coffee.
7. Conventional methods of Western medicine for the treatment of colonic and rectal injuries
The treatment of colonic and rectal injuries is mainly surgical staging treatment, as follows:
First, primary suture repair of perforation or intestinal resection and anastomosis
1. Indications: the time from injury to surgery is within 6 hours; feces leakage is minimal, and abdominal cavity contamination is mild; single colonic or rectal injury, without associated other visceral injuries or minor associated injuries; the patient's overall condition is good; young patients; right hemicolonic injury; routine trauma or stable front line in wartime. The injured personnel can stay in the surgical unit for observation for more than 1 week after surgery.
2. Surgical methods: mainly include perforation suture repair, colon resection and anastomosis, right hemicolectomy and ileocecal anastomosis.
Second, two-stage surgery
1. Indications: the time from injury to surgery exceeds 6 hours; feces pollution in the abdominal cavity is severe; associated with multiple systemic injuries or multiple organ injuries in the abdomen; the patient's overall condition is poor and cannot tolerate long-term surgery; older age; left hemicolonic injury; in wartime, a large number of injured personnel cannot be treated and observed at this medical station and need to be treated and observed for more than one week.
2. Surgical methods: mainly include coloanal anastomosis, suture of damaged intestinal loop with proximal coloanal anastomosis, suture with coloanal anastomosis, and rectal injury suture with sigmoid colon stoma.
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