Extraperitoneal rectal perforation without perineal wound or pelvic fracture.
The present report describes an unusual case of rectal perforation. An 81-year-old female was struck by a truck while walking in the street, and she was sent to a local hospital where fracture of the right subtrochanteric femur was diagnosed. She was admitted, in stable condition, for planned orthopedic operation. Consciousness change and respiratory distress developed 6 hours later. She was then transferred to a trauma center where extraperitoneal rectal perforation was diagnosed. Despite empirical antibiotics and surgical intervention, the patient unfortunately expired 3 days later. Unusual mechanism and incomplete physical examination were the major causes of delayed diagnosis. This case report also discusses the mechanism, classification and management of rectal perforation.
Chen
Isaac Chun-Jen
IC
Emergency Department, Taipei Veterans General Hospital, Taipei, Taiwan, ROC.
Shih
Hsin-Chin
HC
Wen
Yi-Szu
YS
D000063:Accidents, Traffic; D000368:Aged; D000369:Aged, 80 and over; D017809:Fatal Outcome; D005260:Female; D005264:Femoral Fractures / Q000175:diagnosis / Q000601:surgery; D006801:Humans; D012007:Rectum / Q000293:injuries*; D012421:Rupture; D014949:Wounds, Nonpenetrating / Q000175:diagnosis* / Q000209:etiology