2016 Volume 36 Issue 5 Pages 979-982
Laparoscopic surgery is performed for many cases of acute abdomen； however, its application to trauma cases is limited. We present our experiences of laparoscopic surgery in two cases of traumatic rectal injury. In the first, an 80-year-old man fell down on a back scratcher, called a magonote in Japan, and presented with injuries to the rectum, prostate and bladder. Emergency suturing of the rectal lacerated wound was performed, with compression to stop the bleeding. A diagnostic laparoscopy following the rectal repair revealed no peritoneal damage. A loop ileostomy was created for proximal diversion of the fecal stream without laparotomy. On the 128th postoperative day, after the rectovesical fistula had closed spontaneously, the ileostomy was closed. In the second case, a 79-year-old man presented to us with rectal injury caused by an enema. An emergency diagnostic laparoscopy revealed no intra-abdominal organ injuries. A sigmoid colostomy was created for proximal fecal diversion without laparotomy. The patient’s postoperative course was uneventful. The colostomy was closed on the 86th postoperative day. Laparoscopic surgery is useful in some cases of abdominal trauma, such as patients with traumatic rectal injuries, who can be safely managed by diagnostic laparoscopy and diverting colostomy without the need for a laparotomy.
