The patient is a 61-year-old male with a perianal trauma injury caused by a bull horn. The examination was performed under anesthesia to rule out secondary lesions, and a perianal incision/contusion wound was observed close to the sphincter apparatus (Fig. 1). Upon digital rectal examination, no disruptions of the rectal wall were palpable, and rectoscopy ruled out complete mucosal lesions. The study was complemented with endoanal ultrasound to assess sphincter integrity, demonstrating an ascending left pararectal path with laceration of the external anal sphincter (less than 50°) in the middle anal canal (arrows), and complete integrity of the internal anal sphincter (Fig. 2). Due to the septic characteristics of the lesion and its grade (Grade IIIa), we decided not to perform primary sphincter repair, and the surgery was completed with extensive debridement and thorough irrigation. The patient was discharged 48h later. During follow-up, he presented no changes in continence. We conclude that intraoperative endoanal ultrasound is a useful tool for the evaluation of sphincter defects after perianal trauma.
Please cite this article as: Timoteo Delgado A, Falgueras Verdaguer L, Pigem Rodeja A, Farres Coll R. Valoración de la integridad esfinteriana mediante ecografía endoanal intraoperatoria tras traumatismo perianal por asta de toro. Cir Esp. 2021;99:384.
