Document Detail

Complete anal sphincter complex disruption from intercourse: A case report and literature review.
MedLine Citation:
PMID:  22940697     Owner:  NLM     Status:  PubMed-not-MEDLINE    
INTRODUCTION: Anal sphincter injuries are uncommon injuries outside of obstetric practice - but they may cause disastrous complications.
PRESENTATION OF CASE: We present a case of complete anal sphincter disruption from anal intercourse in a 25 year old woman. Clinical management is presented and technical details of the repair are discussed. She had an uneventful post-operative course and good continence after 154 days of follow up.
DISCUSSION: This is one of a handful of reported cases of anal sphincter disruption secondary to anal intercourse. The established risk factors in this case included receptive anal intercourse coupled with alcohol use. We review the pertinent surgical principles that should be observed when repairing these injuries, including anatomically correct repair and appropriate suture choice. There is little evidence to support simultaneous faecal diversion for primary repair of acute perineal lacerations.
CONCLUSION: Acute post-coital sphincter injuries should be treated operatively on an emergent basis, without diversion because they are low energy injuries with minimal tissue loss and excellent blood supply. Although repair of each injury should be individualized, the majority of these injuries do not require concomitant protective colostomy creation.
S O Cawich; L Samuels; I Bambury; C J Cherian; L Christie; S Kulkarni
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Publication Detail:
Type:  Journal Article     Date:  2012-08-13
Journal Detail:
Title:  International journal of surgery case reports     Volume:  3     ISSN:  2210-2612     ISO Abbreviation:  Int J Surg Case Rep     Publication Date:  2012  
Date Detail:
Created Date:  2012-09-11     Completed Date:  2012-10-02     Revised Date:  2013-04-02    
Medline Journal Info:
Nlm Unique ID:  101529872     Medline TA:  Int J Surg Case Rep     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  565-8     Citation Subset:  -    
Copyright Information:
Copyright © 2012 Surgical Associates Ltd. Published by Elsevier Ltd. All rights reserved.
Department of Surgery, University of the West Indies, Mona Campus, Kingston 7, Jamaica.
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