MANAGEMENT OF RECTAL TEARS

Rectal tears have important medicolegal implications, and severe tears have a poor prognosis. Prompt diagnosis, immediate application of fir st aid measures, early referral, use of appropriate definitive treatme nts, and aggressive aftercare will improve the prognosis. The grade of rectal injury will determine the definitive treatment, but there are few guidelines to determine which treatment is best in each case. Bypa ss procedures, such as colostomy and indwelling rectal Liner, have the ir own advantages and disadvantages, but can facilitate healing and pr event life-threatening complications if they are used with minimum del ay. Suture of the tear can be difficult, but should be attempted to ha sten healing and to prevent progression of the tear to a more severe i njury.