bloody rectum...

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EUA to be able to 1. examine extend of "perianal" (vs prineal) wound and
2. do a very thorough and slow rigid sig with ability to insufflate,
wipe and observe.  BaE of no real use here as I see it, and I woudl
suspect that CT with rectal contrast will be of little help as well.
Assuming no other injuries, drain/pack wound, with diligent wound care.
 Given patient's age, one would hope to avoid diverting
colostomy.......
Do you have any photos of the actual wound?  That would help here.

Take care,
Ron

>>> joe.nemeth at staff.mcgill.ca 04/24 7:56 AM >>>
once again:

-30 y.o.female
-straddle injury, picket fence
-sustains "deep" perianal lac.
-DRE: good tone, no blood
-rig. sig.:fresh blood distal rectum ("?maybe ED doc's bloody fingered

DRE exam")
-fleet enema
-repeat sig: same
-CT with rectal contrast: neg.


what next?...


-- 
Dr. Joe Nemeth
Assistant Professor
Emergency Medicine
Montreal General Hospital
Montreal Children's Hospital
McGill University Health Center




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