PROMOTING ACCESS TO AFRICAN RESEARCH

African Journal of Paediatric Surgery

Log in or Register to get access to full text downloads.

Remember me or Register



DOWNLOAD FULL TEXT Open Access  DOWNLOAD FULL TEXT Subscription or Fee Access

The Management of Anorectal Injuries in a Nigerian Paediatric Tertiary Centre

LB Chirdan, AF Uba

Abstract


Background Anorectal injuries are rare in children. Recently there has been an increasing trend towards primary repair without proximal colostomy. This is a review of our experience with anorectal injuries in children in a paediatric tertiary centre in Nigeria.

Patients and Methods All children 15 years or below managed for anorectal injuries in our institution over a 6 year period have been retrospectively reviewed.

Results There were 9 children. Five were boys and 4 were girls. Their ages ranged from 4 days - 15 years (median 8 years). Four injuries were due to blunt trauma while 5 were due to penetrating trauma. Road Traffic Accidents (RTAs) and gunshot injuries accounted for 3 each, 1was iatrogenic during Caesarian delivery, while fall from height and cow horn injury accounted for 1 each. Rectal bleeding was the commonest presenting symptom. Only 3 children presented to the hospital within 12 hours of injury. Six had rectal injuries (2 were intraperitoneal and 4 extrperitoneal, 2 of which had associated anal injuries). Three had anal injuries without rectal injuries. Associated injuries were to the colon 2, urethra 2, vagina 2, bone fracture 2, spleen 1, urinary bladder 1 and scrotum 1. Intraperitoneal injuries were treated by repair and colostomy. Extraperitoneal injuries were treated by repair and proximal colostomy in 3; and repair without colostomy in 1. Anal injuries were repaired in 3 children without proximal colostomy after exclusion of proximal injuries. Four children had wound infection (3 without colostomy, 1 had colostomy). One child with intraperitoneal rectal injury associated with colonic and splenic injury died of overwhelming sepsis and multiple organ failure. Faecal continence was achieved in 4 children with anal injuries, while 1 child who had proximal colostomy is awaiting colostomy closure.

Conclusion The immediate recognition of anorectal injuries in children is vital to a successful outcome. Though primary repair without proximal colostomy is feasible in selected cases wound complication in this group is high.
Key Words: Anorectal injury, children, colostomy, wound complication.
African Journal of Paediatric Surgery Vol.(1)1 2004: 29-32



AJOL African Journals Online