Digital rectal examination in the trauma population: benefits and clinical application | Rare Techy

Several evaluations of the diagnostic utility and utility of direct rectal examination in trauma patients can be found in the current literature. ATLS advises performing a digital rectal exam in trauma patients after first assessing their injuries. Researchers sought to evaluate the diagnostic effectiveness and validity of the digital rectal exam in a trauma population.

The PubMed, Google Scholar, EMBASE, ProQuest, and CINAHL databases were searched between the creation date of each database and August 6, 2022. All studies that examined the reliability of digital rectal examination in trauma patients were included. Elderly in the emergency room or trauma bay. Study results and validity measures were compared and summarized.

A total of nine studies satisfied the inclusion criteria for both adult and pediatric trauma populations. In adults, the sensitivity of digital rectal examination for detecting spinal cord and urinary tract injuries varies from 0% to 50%, while its sensitivity for detecting gastrointestinal tract injuries ranges from 0% to 51%. Digital rectal examination frequently performs poorly in identifying injuries compared with other clinical signs. Digital rectal examination has significant false-negative rates in pediatric trauma groups, ranging from 66% to 100%, and misses all urinary and gastrointestinal injuries and pelvic fractures.

The use of digital rectal examinations in trauma patients has shown little validity and reliability in determining relevant injuries and has little impact on how those injuries are managed. Trauma societies should further clarify the use of digital rectal exams in specific situations and injury types by developing guidelines and algorithms.

Reference: Sciencedirect.com/science/article/pii/S0735675722006982