title: Combined penetrating injury of the perineum and abdominal viscera.
abstract: This is a rare presentation. A farmer aged 52 years old was brought to the emergency service of Government District (Doon) Hospital in the late evening having significant bleeding per rectum. He had injured his perineum on a sharp wooden stick during a fall near a tube well. The wooden stick had been extracted by his relatives, which had resulted in profuse bleeding. The patient was managed with intravenous crystalloids and rushed to the operating theatre for examination under analgesia. Blood transfusion was arranged and the wound explored under general anaesthesia. The patient had unusual associated visceral injuries as well as sphincter, rectum, urinary bladder, ileal loop and mesentery injuries. The injured bowel, mesentery, urinary bladder and rectum were repaired with diversion of the upper pelvic colon. In addition, debridement of the perineal wound with rectal sphincter repair was performed and the presacral space drained. The colostomy was closed after 3 months, and the patient survived and is continent.
authors.affiliation: CMI Hospital Dehradun, Surgery, 54 Haridwar Road, Dehradun, Uttarakhand, 248001, India.
authors.forename: Guru P
authors.initials: GP
authors.lastname: Painuly
authors.forename: Dhirendra Singh
authors.initials: DS
authors.lastname: Negi
references.citation: J Trauma. 1998 Oct;45(4):656-61
references.pmid: 9783600
references.citation: J Trauma. 1990 Sep;30(9):1155-9; discussion 1159-60
references.pmid: 2213949
references.citation: World J Surg. 2000 Jan;24(1):114-8
references.pmid: 10594214
references.citation: Langenbecks Arch Chir. 1990;375(1):55-63
references.pmid: 2308442
references.citation: Am Surg. 1998 Dec;64(12):1136-41
references.pmid: 9843331
references.citation: J Trauma. 2006 Oct;61(4):815-9
references.pmid: 17033545
references.citation: Harefuah. 1995 Mar 1;128(5):276-8, 335
references.pmid: 7744347
references.citation: Chin J Traumatol. 2006 Feb;9(1):56-8
references.pmid: 16393518
references.citation: Am Surg. 1996 Sep;62(9):765-7
references.pmid: 8751772
references.citation: J Pediatr Surg. 2006 Sep;41(9):E1-3
references.pmid: 16952579
references.citation: J Trauma. 1993 Mar;34(3):347-53
references.pmid: 8483173
references.citation: Am Surg. 1991 Jan;57(1):50-5
references.pmid: 1796798
references.citation: Am Surg. 1990 Aug;56(8):507-10
references.pmid: 2375553
references.citation: Ann Surg. 1989 May;209(5):600-10; discussion 610-1
references.pmid: 2705824
references.citation: Khirurgiia (Mosk). 2000;(6):37-9; discussion 40
references.pmid: 10900842
references.citation: Chirurg. 2001 Dec;72(12):1402-6
references.pmid: 11824023
references.citation: Swiss Surg. 1996;(1):4-9
references.pmid: 8871256
references.citation: J Natl Med Assoc. 1993 Jun;85(6):460-3
references.pmid: 8366537
references.citation: Am J Surg. 1984 Dec;148(6):806-8
references.pmid: 6507755
references.citation: Am Surg. 1987 Apr;53(4):215-9
references.pmid: 3579027
references.citation: Arq Gastroenterol. 1990 Jul-Sep;27(3):120-5
references.pmid: 2099139
references.citation: J Trauma. 2007 Feb;62(2):325-9
references.pmid: 17297321
references.citation: J Med Assoc Thai. 1993 Oct;76(10):576-80
references.pmid: 7964229