Reparation of Traumatic Injury of Anal Sphincter: Case Report and Review of Surgical Treatment

Abstract

Summary Anal sphincter injuries are rare and usually related to obstetric injuries. Other more frequent causes of a violent injury of the anal muscles (including the rectum) are war injuries, violent civil injuries, iatrogenic injuries during surgeries, sexual injuries and accidental injuries. Accidental injuries are extremely rare and, searching Medline, Scopus and Medscape for the past five years, I have found only a few descriptions of such injuries. Almost all such articles are of “the case study type”. This paper presents two cases of accidental anal muscle injuries which were successfully operated by using the reconstructive surgery procedure. One case is about fecal incontinence due to a major muscle injury, and the other is about a partial injury of the external anal muscle in two places. The diagnoses were made by palpation and operative exploration. The anal manometry, electromyography and transanalsonography were not used. By presenting two accidental anal sphincter injuries and by reviewing the data from the published works, the aim of the paper was to help us determine when and how to operate and whether an additional diagnosis is always necessary. This article focuses on rare and specific but frequently very serious injuries. The reparation by primary sphincteroplasty gives excellent results.