A well-managed case of discontinuous anorectal injury caused by a personal watercraft treated by combining surgery and colonoscopy

Background

Anorectal injury caused by personal watercraft (PWC)-related trauma is rare. However, PWC accidents have increased recently, and since patients tend to be younger, treatment strategies should consider anal function preservation in addition to saving lives.

Case Presentation

A 30-year-old female patient who fell into the water when a PWC suddenly accelerated and injured her perineum with a forceful water jet was transported to our hospital. On examination, she was diagnosed with a traumatic rectal perforation with intraperitoneal findings and an anorectal injury. Emergency surgery, which involved direct suturing, temporary colostomy with intraoperative endoscopy for the rectal perforation, and anorectal reconstruction, was performed. The patient was discharged on postoperative day 19 without complications, and the colostomy was closed 5 months postoperatively.

Conclusion

We encountered a case of multiple noncontinuous anorectal injuries due to a PWC accident that was successfully treated using a combination of surgery and intraoperative endoscopy.