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Perineal injuries in children

L W Jones1, D H Bass

  • 1Trauma Unit, University of Cape Town, Republic of South Africa.

The British Journal of Surgery
|September 1, 1991
PubMed

Insights

Perineal injuries in children under 13 are often caused by falls, but severe cases stem from trauma or abuse. Surgical repair outcomes for severe perineal tears depend on early colostomy use.

Area of Science:

  • Pediatric Surgery
  • Trauma Surgery
  • Child Abuse Pediatrics

Background:

  • Perineal injuries in children are a significant concern.
  • A 12-year study analyzed 463 pediatric cases.

Purpose of the Study:

  • To investigate the causes, treatment, and outcomes of perineal injuries in children.
  • To identify factors influencing severe injury and surgical repair success.

Main Methods:

  • Retrospective analysis of 463 children under 13 treated for perineal injuries over 12 years.
  • Categorization of injuries by cause (falls, trauma, abuse, enema) and severity (degree of laceration).
  • Evaluation of treatment approaches (suturing, granulation, colostomy) and sepsis rates.

Main Results:

  • Falls were the most common cause, while motor vehicle trauma and rape led to severe injuries.
  • Physical or sexual abuse was present in 38% of cases.
  • Third-degree lacerations occurred in 6% of children, with one fatality.
  • Surgical repair outcomes for severe tears were linked to the use of early defunctioning colostomy.

Conclusions:

  • While falls are common, severe perineal injuries in children often result from abuse or trauma.
  • Early defunctioning colostomy is crucial for successful surgical management of severe perineal lacerations in pediatric patients.

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