Rectal injuries are often caused by industrial and agricultural accidents, traffic accidents, daily mishaps, and fights, with closed abdominal injuries being the most common.

bubble_chart Clinical Manifestations

1. abdominal pain and vomiting: due to
2. colorectal perforation or massive damage, feces from the intestinal cavity spill into the abdominal cavity, leading to abdominal pain
3. vomiting. The pain initially localizes to the perforation site and then spreads throughout the entire abdomen, resulting in diffuse peritonitis with generalized abdominal pain.
4. Peritoneal irritation signs: abdominal tenderness
5. muscle rigidity and rebound tenderness. The pain is most pronounced at the site of perforation or rupture.
6. Borborygmi are weakened or even absent.
7. Digital rectal examination: in cases of low rectal injury, a hollow sensation can be palpated at the injury site, and blood may be present on the examining finger. In colon injuries, only a minority of cases show blood on the finger.

bubble_chart Auxiliary Examination

1. Blood routine examination: Increased white blood cell count and neutrophils.
2. X-ray: For closed injuries, when the patient's condition allows for an upright X-ray, free gas under the diaphragm can often be detected.
3. Ultrasound, CT, MRI: If the above examinations cannot provide a clear diagnosis, any one or two of these tests can be selectively used to assist in diagnosis.

bubble_chart Diagnosis

1. Caused by direct trauma or associated with injury during pelvic fracture.
2. Rupture above the peritoneal reflection resembles peritonitis caused by colon injury; rupture below the reflection can lead to perirectal infection without signs of peritonitis.
3. Intrarectal bleeding may be discharged from the anus, and rectal examination reveals blood or palpable rectal rupture.

bubble_chart Treatment Measures

1. Rupture above the peritoneal reflection: Exploratory laparotomy should be performed. For small ruptures with mild contamination, repair can be performed with proximal sigmoid colostomy or postoperative anal tube decompression; for large ruptures, rectal resection and anastomosis are recommended, along with sigmoid colostomy during seasonal epidemics.
2. Rupture below the peritoneal reflection: Adequate drainage of the perirectal space should be performed, along with sigmoid colostomy. The colostomy can be closed after the rectal wound heals.