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Fri May 25 03:14:51 BST 2007

I was taught that the rectal washout/presacral drain thing was something learned from war casualties, where soldiers are constipated (for obvious reasons) and (more importantly) the velocity of bullets is higher than civilian gun trauma; then a ordinary civilian getting a penetrating rectal trauma didn't need routine washout/drainage, just repair and diversion... But as people don't shoot each other a lot where I live, I don't have much experience on this...

JP

----- Message initial ----
De : Ronald Gross <Rgross at harthosp.org>
À : "Trauma & Critical Care mailing list" <trauma-list at trauma.org>
Envoyé le : jeudi 24 mai 2007, 07 h 29 min 50 s
Objet : Re: [PHISH] Re: PELVIC GSW

I guess it still depends on who you read and who you talk to.....

>>> Ronald Simon <Traumamd at nyc.rr.com> 5/23/2007 11:04 PM >>>
I thought rectal washouts were out along with the presacral drain?
ron simon

Ronald Gross wrote:
> Looks to me like a rectal/rectosigmoid wound.  I would explore, do a
> rigid sig in the OR, localize the injury, and do a colostomy and
> hartmanns with rectal washout.
>
> What did you do, and how did he do?
>
> Ron
> Ronald I. Gross, MD, FACS
> Associate Director of Traumatology
> Hartford Hospital
> Chair, ACS CT Committee on Trauma
> 80 Seymour Street
> Hartford, CT  06102
> 860-545-4187 Phone
> 860-545-2006 Fax
> rgross at harthosp.org 
>   
>>>> "Fernando Aguilar" <draguilarrevelo at gmail.com> 05/23/07 7:10 PM
>>>
>>>>         
> I would like to hear your approach to the following case:
> Male, 32, gunshot wound to left lateral inferior flank (see picture
01),
> no
> exit wound, arrive ER 20 min. after injury.  BP: 120/75, P: 90,
SatO2:
> 98%,
> no cristalloids given.
> Abdomen tender in lower quadrants. FAST Neg.  Rectal: normotonic,
feces
> with
> little blood.  Pulses: OK.
> Abdominopelvic x-ray taken (see picture 02)
> CAT Scan shown (pictures 03, 04, 05)
>
> My hospital is a General Hospital and is one of the 3 mayor hospital
at
> my
> country.  We manage all trauma patients.
>
> Dr. Fernando Aguilar
> General Surgeon
> Calderon Guardia General Hospital
> San JosÃ©, Costa Rica
>
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[PHISH] Re: PELVIC GSW