Trauma to the perineum, anus, rectum and colon

The problems which arise from wounds of violence to the perineum, anus, rectum and colon have been discussed in terms of anatomic structure. There are two types of violence to this region, namely, direct and indirect. A review of the regional anatomy denotes five cardinal sites of involvement from deep penetrating wounds, namely the urogenital region, the anal region, the ischiorectal fossa, the retroperitoneal infrapelvic space and the pelvis or peritoneal cavity. In the early postaccident period the ischiorectal fossa and the infrapelvic retroperitoneal space are clinically silent regions. Serious complications and death from infection may be prevented if all patients are thoroughly studied by proctosigmoidoscopy and properly treated. In consideration of the bizarre types of injuries preoperative, operative and postoperative surgical treatment have been presented. The case reports clearly emphasize most ot the surgical principles involved.