Traumatic small bowel perforation in a case of a perineal hernia

Perineal hernias following pelvic surgery are rare. Traumatic small bowel perforation in a patient with a perineal hernia is yet to be described. This case report describes a 69-year-old female who following an abdominoperineal resection for cancer developed a perineal hernia and unfortunately sustained perineal trauma. She presented with peritonitis and findings on laparotomy were that of two points of perforation to terminal ileal loop adherent to perineal defect. Resection and a side-to-side anastomosis performed. Repair of the hernia using mesh was considered but not performed due to risk of mesh infection. Perineal hernias have become more common since the advent of laparoscopic pelvic surgery. Although various methods have been described to repair these hernias, there is lack of robust evidence supporting one repair technique over others.