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Erschienen in: Techniques in Coloproctology 11/2014

01.11.2014 | Review

Penetrating injury to the buttock: an update

verfasst von: R. Lunevicius, D. Lewis, R. G. Ward, A. Chang, N. E. Samalavicius, K. M. Schulte

Erschienen in: Techniques in Coloproctology | Ausgabe 11/2014

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Abstract

Clinical research on penetrating injury to the buttock is sparse and largely limited to case reports and clinical series. The purpose of this paper is to provide a detailed overview of literature of the topic and to propose a basic algorithm for management of penetrating gluteal injuries (PGI). MEDLINE, EMBASE, Cochran, and CINAHL databases were employed. Thirty-seven papers were selected and retrieved for overview from 1,021 records. PGI accounts for 2–3 % of all penetrating injuries, with a mortality rate up to 4 %. Most haemodynamically stable patients will benefit from traditional wound care and selective non-operative management. When gluteal fascia injury is confirmed or suspected, a contrast-enhanced CT-scan provides the most accurate injury diagnosis. CT-scan-based angiography and endovascular interventions radically supplement assessment and management of patients with penetrating injury to the major buttock and adjacent extra-buttock arteries. Immediate life-saving damage-control surgery is indicated for patients with hypovolemic shock and signs of internal bleeding. A universal basic management algorithm is proposed. This overview shows that penetrating injury to the buttock should be regarded as a potential life-threatening injury, and therefore, patients with such injuries should be managed in trauma centres equipped with hybrid operating theatres for emergency endovascular and open surgery for multidisciplinary teams operating 24/7.
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Metadaten
Titel
Penetrating injury to the buttock: an update
verfasst von
R. Lunevicius
D. Lewis
R. G. Ward
A. Chang
N. E. Samalavicius
K. M. Schulte
Publikationsdatum
01.11.2014
Verlag
Springer Milan
Erschienen in
Techniques in Coloproctology / Ausgabe 11/2014
Print ISSN: 1123-6337
Elektronische ISSN: 1128-045X
DOI
https://doi.org/10.1007/s10151-014-1168-2

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