Anorectal trauma: the use of computed tomography scan in diagnosis

Anorectal injuries represent a relatively uncommon but clinically critical diagnosis in trauma. Anorectal injuries may be the result of penetrating injuries to the pelvis and perineal area as well as severe blunt traumatic injuries, often with pelvic fractures. The purpose of this review is to discuss injuries to the anorectal region sustained in trauma, specifically, in the application of multidetector computed tomography technology to these imaging diagnoses. An understanding of the pertinent anatomy is critical in characterization of these injuries using computed tomography (CT). Additionally, the subsequent clinical management decisions and how they are impacted by severity and location of injury in anorectal trauma is useful to the radiologist. This should serve to highlight the specific areas and injury distinctions that deserve our particular attention given possible changes in the ensuing management approaches. CT protocol issues including the use of oral, rectal, and intravenous contrast, as necessary, are relevant in maximizing the diagnostic accuracies of CT in anorectal trauma. This review serves to discuss and illustrate these pertinent issues, approaching penetrating and blunt trauma separately, with the emphasis on multidetector computed tomography in diagnosis.