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Hydrostatic anorectal injury caused by fall from jet-ski
Adi Litmanovich1,2, Dmitri Nordkin1,2, Anna Vakarev1,2
1Bar-Ilan University Faculty of Medicine, Tzfat, Israel.
BMJ Case Reports
|June 22, 2021
Summary
A rare jet-ski accident caused a severe hydrostatic perineal injury in a teenage girl. Successful treatment involved surgical repair, colostomy, and extensive pelvic floor physiotherapy, ultimately restoring continence.
Area of Science:
- Trauma Surgery
- Gastroenterology
- Pediatric Surgery
Background:
- Jet-ski accidents can cause severe, unusual injuries.
- Hydrostatic perineal injuries are rare but can result in significant anorectal trauma.
Observation:
- A 14-year-old female sustained a complex hydrostatic perineal injury after ejection from a jet-ski.
- She presented with rectal bleeding, abdominal pain, and signs of anorectal injury, including free air and fluid.
- Initial diagnostic proctoscopy and exploratory laparotomy confirmed an intraperitoneal rectal wall tear.
Findings:
- Surgical repair of the rectal tear and a protective loop colostomy were performed.
- Initial functional assessments (anal manometry, ultrasound, EMG) indicated poor outcomes.
- After 17 months of pelvic floor physiotherapy and biofeedback, the colostomy was successfully reversed.
Implications:
- This case highlights a rare mechanism of severe anorectal injury.
- Early surgical intervention followed by targeted rehabilitation can lead to favorable functional recovery.
- Emphasizes the importance of protective gear and safe practices during recreational watercraft use.
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