Primary sphincter repair in anorectal trauma

Area of Science:

• Trauma Surgery
• Colorectal Surgery
• Surgical Reconstruction

Background:

• Anorectal trauma can result from various mechanisms, including penetrating injuries and high-energy impacts.
• Severe injuries to the rectum and anal sphincters pose significant challenges to functional recovery and continence.
• Previous management strategies for such injuries have varied, with outcomes often dependent on the extent of damage and treatment approach.

Observation:

• Two patients presented with severe anorectal trauma attributed to
• fist fornication
• a specific type of penetrating injury.
• Initial management involved thorough irrigation, temporary colostomy for fecal diversion, surgical drainage, and broad-spectrum antibiotic administration.
• Surgical intervention included primary repair of the rectal wall and anal sphincters.

Findings:

• Both patients underwent successful primary repair of the rectum and anal sphincters without any immediate postoperative complications.
• Following the surgical intervention and colostomy closure, both individuals experienced a complete return of fecal continence.
• The treatment protocol demonstrated efficacy in restoring both structural integrity and functional capacity of the anorectal region.

Implications:

• Primary repair of the anal sphincters should be strongly considered for severe anorectal trauma, including that resulting from penetrative sexual acts.
• This approach offers a viable option for achieving complete continence restoration in patients with complex anorectal injuries.
• Further research into standardized management protocols for diverse anorectal trauma etiologies is warranted to optimize patient outcomes.