[Perineal rupture and anorectal incontinence with traumatic sacroiliac dislocation. Treatment and functional results]

A case of traumatic sacro-iliac disruption with severe perineal rupture and ano-rectal incontinence by total unilateral laceration of the levator ani muscle is reported. The use of parenteral hyperalimentation as a "medical colostomy" has been successfully applied maintaining the patient's nutritional status while healing of the wound occurred. This gives the surgeon an option for the management of such a severe sphincter's laceration: without resorting to preliminary colostomy. The general management of patients with perineal and rectal trauma is reviewed. The prerequisite of bone fracture consolidation prior soft tissue repair is emphasized. Progressive recovery of ano-rectal continence is demonstrated by repeated ano-rectal manometry.