Loading...
Most major emergency medicine and trauma textbooks as well as the Advanced Trauma Life Support (ATLS) guidelines recommend performing a digital rectal exam on every trauma patient as part of the secondary survey. The exam is intended to detect abnormal sphincter tone as a sign of spinal cord injury, presence of rectal blood as a sign of intestinal injury, disruption of the rectal wall as a sign of rectal injury, palpation of bone fragments as a sign of pelvic fracture, and high-riding position of the prostate as a sign of urethral injury. To date, no published studies support the recommendation.
Researchers performed a retrospective chart review of patients with blunt (91%) or penetrating trauma who received a rectal exam as part of their se…