Severe hemoperitoneum after patient self-induced fecal evacuation.

Case Rep Med

General Surgery Department, Emergency Surgery Service, University of Ferrara, Corso Giovecca 203, 44100 Ferrara, Italy.

Published: November 2011

An increasing incidence of rectal injuries following patient self-induced harmful acts, aimed to sexual or laxatives porpouses, is a fact reported in literature (El-Ashaal et al., 2008). We herein report a case of severe hemoperitoneum related to a middle and upper rectal third seromuscolar tear caused by a self-induced fecal evacuation by means of an arrow with a covered cork tip. An urgent intestinal diversion by means of a Hartmann's operation was performed. The clinical case is presented in relation to the literature debate, regarding the issue of primary repair or resection and anastomosis versus fecal diversion for penetrating rectal injuries (Fabian, 2002; Cleary et al., 2006; Office of the Surgeon General, 1943; Busic et al., 2002). In conclusion, the importance of avoiding an anastomotic breakdown in a patient undergoing a hemorrhagic shock is highlighted.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3162978PMC
http://dx.doi.org/10.1155/2011/313841DOI Listing

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