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coloproctology

, Volume 41, Issue 1, pp 49–62 | Cite as

Pfählungsverletzungen und rektale Fremdkörper

  • M. RoblickEmail author
  • S. Farke
CME
  • 18 Downloads

Zusammenfassung

Fremdkörper und Pfählungsverletzungen sind seltene proktologische Erkrankungen. Bei penetrierenden Traumata oder Komplikationen von in den Analkanal oder das Rektum eingeführten Fremdkörpern kann es zu lebensbedrohlichen Verletzungen kommen, deren Diagnostik und Therapie hohe Anforderungen an das Management der Patienten stellen. In der Behandlung von Pfählungsverletzungen stehen die Diagnostik mit dem Erkennen des Ausmaßes der Schädigung und die zielgerichtete chirurgische Therapie im Vordergrund. Insbesondere bei schwersten Verletzungen ist eine zumindest temporäre Stomaanlage unvermeidbar. Bei Fremdkörpern im Rektum ist in vielen Fällen die aktive Entfernung notwendig, da größere oder besonders geformte Fremdkörper nicht ohne Intervention abgehen. Dabei muss auf eine vollständige Entfernung ohne zusätzliche Verletzung des Rektums geachtet werden. Oberhalb des rektosigmoidalen Übergangs liegende Fremdkörper müssen in der Regel über einen transabdominellen Zugang entfernt werden.

Schlüsselwörter

Darmperforation Fremdkörpermigration Operative Stomata Laparoskopie Transanale endoskopische Operation 

Impalement injuries and rectal foreign bodies

Abstract

Foreign body and impalement injuries are rare proctological conditions. Penetrating trauma and complications of foreign bodies inserted in the anal passage or rectum can result in life-threatening injuries. The diagnostics and treatment of these injuries place high demands on the management of patients. In the treatment of impalement injuries priority is given to the diagnostics, with recognition of the extent of the injury and targeted surgical treatment. Particularly in cases of severe injuries at least a temporary stoma placement is unavoidable. For foreign bodies in the rectum an active removal is necessary in many cases because larger and unusually shaped foreign bodies cannot be removed without a surgical intervention. In this respect attention must be given to a complete removal without causing additional injuries to the rectum. Foreign bodies situated above the rectosigmoid junction must as a rule be removed via a transabdominal access route.

Keywords

Intestinal perforation Foreign body migration Surgical stomas Laparoscopy Transanal endoscopic surgery 

Notes

Einhaltung ethischer Richtlinien

Interessenkonflikt

M. Roblick und S. Farke geben an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine von den Autoren durchgeführten Studien an Menschen oder Tieren.

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Copyright information

© Springer Medizin Verlag GmbH, ein Teil von Springer Nature 2019

Authors and Affiliations

  1. 1.End- und Dickdarmzentrum Hannover (edh)HannoverDeutschland
  2. 2.Allgemein- und Viszeralchirurgie, minimal-invasive Chirurgie und KoloproktologieSt. Marien-Krankenhaus BerlinBerlinDeutschland

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