title: Extraperitoneal rectal perforation without perineal wound or pelvic fracture.
abstract: 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.
authors.affiliation: Emergency Department, Taipei Veterans General Hospital, Taipei, Taiwan, ROC.
authors.forename: Isaac Chun-Jen
authors.initials: IC
authors.lastname: Chen
authors.forename: Hsin-Chin
authors.initials: HC
authors.lastname: Shih
authors.forename: Yi-Szu
authors.initials: YS
authors.lastname: Wen
mesh_terms: 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