Early Sphincter Repair Following Acute Perineal Trauma: Complete Functional Recovery at 4-Month Follow-Up
El mustapha Halim
*
Department of Visceral Surgery II, Mohammed V Military Teaching Hospital, Rabat, Morocco.
Laraqui Hicham
Department of Visceral Surgery II, Mohammed V Military Teaching Hospital, Rabat, Morocco.
Abderrahman Elhjouji
Department of Visceral Surgery II, Mohammed V Military Teaching Hospital, Rabat, Morocco.
Mohammed Fahssi
Department of Visceral Surgery II, Mohammed V Military Teaching Hospital, Rabat, Morocco.
Mbarek Yaka
Department of Visceral Surgery II, Mohammed V Military Teaching Hospital, Rabat, Morocco.
Nouredine Njoumi
Department of Visceral Surgery II, Mohammed V Military Teaching Hospital, Rabat, Morocco.
Abdelmounim Aitali
Department of Visceral Surgery II, Mohammed V Military Teaching Hospital, Rabat, Morocco.
*Author to whom correspondence should be addressed.
Abstract
Acute perineal trauma with sphincter rupture constitutes a functional emergency requiring multidisciplinary management (Ait Laalim et al., 2013). We report a case of early surgical repair with mid-term follow-up.
Case Report : A 32-year-old healthy male presented with complete external anal sphincter (EAS) rupture after a fall onto a metallic object. Despite initially reassuring findings, sphincter hypotonia developed by day 5, confirmed by Magnetic resonance imaging (120° defect at 9 o'clock). Direct sphincterorrhaphy was performed on day 7. At 4-month follow-up, the patient achieved full functional recovery (Wexner score = 1, normalized manometric pressures) (Thierry and Abramowitz, Roche and Ris, 2022, Yashoda Hospitals, 2023, CNGOF, 2024).
This case highlights the importance of sequential clinical/MRI evaluation and optimal outcomes of early anatomic repair (<10 days) for non-obstetric traumatic sphincter injuries.
Keywords: Perineal trauma, sphincter rupture, direct sphincterorrhaphy, Pelvic MRI, biofeedback therapy