[A recto-sigmoid lesion due to trans-anal aspiration. Apropos of a case]

Abstract

A three year old boy presented a transanal evisceration of the rectum after sitting over a non covered drain site of a swimming pool. Peritonitis led to laparatomy 24 hours later. The high rectum was found to be necrotic and perforated. A protecting sigmoïd loop colostomy was performed with out any rectocolic resection. Five months later, resection of the fibrosed high rectum and end to end anastomosis between sigmoïd and low rectum was done. The colorectal function was quickly restored. Continence is now normal with a follow-up of 18 months. Pathogenesis of transanal suction may be as follows: relaxation of perineal muscles and anal sphincter during sitting position permit transanal evisceration by suction. Such lesions are rare (less than 10 cases reported). The therapeutic choice, between initial reparation and drainage associated, with protecting colostomy is discussed.