caa a22 4500 606247955 CHVBK 20210128101348.0 cr unu---uuuuu 210128e20150801xx s 000 0 eng 10.1007/s12262-015-1283-y doi (NATIONALLICENCE)springer-10.1007/s12262-015-1283-y No Evidence Supporting the Routine Use of Digital Rectal Examinations in Trauma Patients [Elektronische Daten] [Salvatore Docimo Jr., Laurence Diggs, Laura Crankshaw, Young Lee, Fausto Vinces] Digital rectal exams (DRE) are routinely used on trauma patients during the secondary survey as recommended by current Advanced Trauma Life Support (ATLS) protocols. However, recent literature has called the blanket use of the DRE on each trauma patient into question. The purpose of this study was to evaluate the efficacy of the DRE as a diagnostic tool in the setting of urethral, spinal cord, small bowel, colon, and rectal injuries and determine if it can be eliminated from routine use in the trauma setting. Trauma patients with small bowel, colon, rectal, urethral, and spinal cord injuries, age of 18years or older, and a noted DRE were included. Exclusion criteria included an age less than 18, patients who received paralytics, a Glasgow Coma Scale (GCS) of 3, and a history of paraplegia or quadriplegia. One-hundred eleven patient records were retrospectively reviewed. Ninety-two male (82.9%) and 19 (17.1%) females with a GCS of 13.7 were evaluated. Sixty-two (55.9%) injuries were penetrating with 49 (44.1) being blunt. The DRE missed 100% of urethral, 91.7% of spinal cord, 93.1% of small bowel, 100% of colon, and 66.7% of rectal injuries. For injuries confirmed with radiologic modalities, the DRE missed 93.3%. For injuries confirmed on exploratory laparotomy, the DRE missed 94.9%. The DRE has poor sensitivity for the diagnosis of urethral, spinal cord, small bowel, and large bowel injury. The DRE was found to be themost sensitive in the setting of rectal injuries. The DRE offers no benefit or predictive value when compared to other imaging modalities. Association of Surgeons of India, 2015 Digital rectal exam in trauma nationallicence Trauma protocol nationallicence Trauma diagnostics nationallicence Rectal exam and bowel injury nationallicence Rectal exam and urethral injury nationallicence Rectal exam and spinal cord injury nationallicence Docimo Jr. Salvatore Department of Surgery, NYU Lutheran Medical Center, 150 55th Street, 11220, Brooklyn, NY, USA aut Diggs Laurence NYU Lutheran Medical Center, 150 55th Street, 11220, Brooklyn, NY, USA aut Crankshaw Laura NYU Lutheran Medical Center, 150 55th Street, 11220, Brooklyn, NY, USA aut Lee Young NYU Lutheran Medical Center, 150 55th Street, 11220, Brooklyn, NY, USA aut Vinces Fausto Department of Surgery, St. Barnabas Hospital, 4422 Third Avenue, 10457, Bronx, NY, USA aut Indian Journal of Surgery Springer India 77/4(2015-08-01), 265-269 0972-2068 77:4<265 2015 77 12262 https://doi.org/10.1007/s12262-015-1283-y text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 research-article jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s12262-015-1283-y text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Docimo Jr Salvatore Department of Surgery, NYU Lutheran Medical Center, 150 55th Street, 11220, Brooklyn, NY, USA aut NATIONALLICENCE 700 1- Diggs Laurence NYU Lutheran Medical Center, 150 55th Street, 11220, Brooklyn, NY, USA aut NATIONALLICENCE 700 1- Crankshaw Laura NYU Lutheran Medical Center, 150 55th Street, 11220, Brooklyn, NY, USA aut NATIONALLICENCE 700 1- Lee Young NYU Lutheran Medical Center, 150 55th Street, 11220, Brooklyn, NY, USA aut NATIONALLICENCE 700 1- Vinces Fausto Department of Surgery, St. Barnabas Hospital, 4422 Third Avenue, 10457, Bronx, NY, USA aut NATIONALLICENCE 773 0- Indian Journal of Surgery Springer India 77/4(2015-08-01), 265-269 0972-2068 77:4<265 2015 77 12262