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Anal sphincter injury is a therapeutic challenge. We present a complex repair in a setting with limited resources.
A 17-year-old female suffered an accident with great perineal trauma, arriving at our medical center 7 days after the accident. She presented significant sepsis and complete incontinence1,2.
Significant injury was observed to the perineal body, sphincters and rectal wall. The vaginal wall remained intact.
Sphincter reconstruction and associated colostomy were planned. During the postoperative period, we observed progressive dehiscence of the sutures, requiring revision surgery with a second sphincter repair.
The patient’s evolution was slow but showed favorable healing and satisfactory final results 3 months later.
References
[1]
S. Chase, R. Mittal, M.R. Jesudason, S. Nayak, B. Perakath.
Anal sphincter repair for fecal incontinence: experience from a tertiary care centre.
Indian J Gastroenterol., 29 (2010), pp. 162-165
[2]
S.H. Emile, M. Youssef, H. Elfeki, W. Thabet, H. Elgendy, W. Omar, et al.
Effect of age, patient’s sex, and type of trauma on the correlation between size of sphincter defect and anal pressures in posttraumatic fecal incontinence.
Surgery., 160 (2016), pp. 1318-1325
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