Involuntary defaecation in acutely injured patients: a useful clinical sign.

The phenomenon of involuntary defaecation following acute, severe injuries has never been documented before, but has been noted by those who work in major trauma units. The exact cause of the phenomenon is unknown. We prospectively noted 14 patients who involuntarily defaecated in a 3-month period and analysed their clinical findings retrospectively. Involuntary defaecation occurred only in patients with severe penetrating or blunt injuries. In those with precordial stabs, involuntary defaecation was particularly predictive of cardiac injury, and in all injuries was associated with higher surgical intervention and mortality rates. The occurrence of involuntary defaecation in injured patients is a useful sign that nearly always indicates the need for urgent intervention.