Ioannis Staikos, Panagiotis Papamichalis,Anna Ziogkou,Antonios Koutalos,Dimitrios Papadopoulos,Evangelos Alexiou,Konstantinos Bouliaris,Konstantinos Malizos,Matthaios Efthimiou,Paraskevi Hatzikomnitsa,
Anorectal Avulsion: Reporting a Rare Case of Rectal Trauma and Review of the Literature
Surgical Case Reports
2019
2613-5965
http://dx.doi.org/10.31487/j.SCR.2019.06.14
https://www.sciencerepository.org/anorectal-avulsion-reporting-a-rare-case-of-rectal-trauma_SCR-2019-6-114 
Abstract: Background: Anorectal avulsion is a rare rectal injury and it is the result of severe blunt pelvic trauma. In
this type of injury, the anus and sphincters are detached from the perineum and are displaced cranially and
ventrally. Treatment is challenging and only a few reports are available.
Case presentation: We report a case of 49-year-old male patient who was referred to our hospital in a septic
condition 10 days after a complex crush pelvic trauma with anorectal avulsion. The treatment included
external pelvic fixation, control of the pelvic sepsis, sigmoidostomy and negative-pressure therapy of the
perineal wound. Salvage of the anus could not be done. The patient was discharged after 90 days suffering
from neurologic deficits of both lower extremities and he followed a long-term rehabilitation program.
Conclusion: Severe perineal injuries with anorectal avulsion are associated with significant morbidity and
mortality. Due to the rarity of this entity treatment is not standardised and requires a multidisciplinary
approach involving general surgeons, orthopaedics, intensivists and rehabilitators. Any effort for anal
reconstruction should be done, if possible, early in the treatment course.Keywords: Complex pelvic trauma, rectal injury, anorectal avulsion