[Strategy and technique in perineal impalement injuries]

Injuries of the anal sphincter and the pelvic floor are rare and have a large range of variations. This report is based upon 28 patients with perineal injuries treated in a 17-year period. Mortality depends on accompanying injuries. The degree of the injury determines the functional result. Proximal diversion and drainage represent the standard treatment for intra-abdominal rectal injuries. In extraperitoneal rectal injuries diversion, presacral drainage and distal rectal washout is recommended. Loss of continence is the most severe complication of injuries of the anal sphincter. The best results are obtained by primary repair.