| Abstract: | We have reviewed the management of twentynine casualties with rectal injuries terated in Vietnam. A high incidence of virulent complications and a 22.2 per cent mortality occurred in eighteen casualties treated by conventional means with a divided sigmoid colostomy, rectal repair when feasible, and presacral drainage. The complications and deaths were invariably related to pelvic sepsis. Distal washout to prevent continued contamination from fecal material remaining in the defunctionalized rectosigmoid was employed in ten casualties in addition to the conventional measures. This resulted in a striking reduction in complications and no mortality. We also stress the importance of prompt diagnosis, direct control of hemorrhage, proper management of associated injuries, and adequate debridement. |
