[Management of traumatic anal incontinence at the University Hospital Center in Abidjan, Ivory Coast: findings in a 12-case series].

Post-traumatic anal incontinence is a severely disabling condition. The purpose of this retrospective study was to evaluate management of 12 cases observed in a surgical setting in Ivory Coast. There were 8 men and 4 women with a mean age of 30 years. The causes of trauma were road accident in 6 cases, impalement in 2, assault in 2, and iatrogenic trauma in 2. Diagnosis of the sphincter lesion was made by clinical assessment only. The lesion was located on the anterior aspect of the sphincter in 3 cases and on the lateral aspect (left or right) in 9 cases. Direct suture was used for first-intention repair in all cases. In the 3 patients presenting lesions located on the anterior aspect, direct suture was associated with myorrhaphy of the levator ani. Temporary left iliac colostomy was performed in all cases. Repair was successful in 11 patients (92%) and unsuccessful in 1. The patient in whom treatment failed underwent graciloplasty with fair results. In this study direct repair achieved good results despite our poor technical facilities. Although these results are encouraging, better management of these injuries would require diagnostic equipment such as endorectal ultrasonography and anal electromyography.