As he attempts to flee, he is shot on the left side by the attacker. He is brought to the trauma center by the paramedics. He is immobilized on a back board. Because the patient is hemodynamically stable, preoperative workup can be undertaken. Rigid proctoscopy reveals a laceration of the rectum about 6 cm from the dentate line.
Pulses are intact and equal in both legs.
Abdominal films reveal no intraabdominal bullets. In the OR, a loop colostomy is performed to divert the fecal stream. This approach also allows for evaluation of the ureters. No other injuries are identified. Presacral closed-suction drains are placed.