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Case Reports
. 2025 Jan 29;17(1):e78186.
doi: 10.7759/cureus.78186. eCollection 2025 Jan.

Anal Sphincter Disruption in Open Pelvic Fractures: A Case Report Highlighting the Importance of Early Intervention

Rafique Umer Harvitkar  1 , Alfredo Tonsi  2 , Hussein Al-Najjar  1 , Ioannis Hannadjas  1 , Mariyam Shaheed  1
Affiliations
Case Reports

Anal Sphincter Disruption in Open Pelvic Fractures: A Case Report Highlighting the Importance of Early Intervention

Rafique Umer Harvitkar et al. Cureus. .

Abstract

Anal sphincter injuries, often accompanying perineal trauma, are closely associated with pelvic fractures (PFs). If unrecognized and untreated, these injuries can lead to sepsis and fecal incontinence. We present the case of a 25-year-old male patient who sustained severe trauma, resulting in unstable open PFs and associated perineal injuries, including anal sphincter damage. The patient was managed with an early diverting colostomy to prevent pelvic sepsis, followed by staged reconstruction of the pelvic ring. This case underscores the importance of a systematic and thorough approach to managing sphincter injuries in post-trauma care. Clinicians must maintain a high index of suspicion for perineal injuries in patients with open PFs, as early intervention can significantly improve functional outcomes.

Keywords: anal sphincter injury; diverting colostomy; pelvic fracture; perineal injury; sepsis.

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Conflict of interest statement

Human subjects: Consent for treatment and open access publication was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

Figures

Figure 1
Figure 1. 3D CT scan of PF with displacement. The yellow arrow indicates the fracture site
PF: pelvic fracture
Figure 2
Figure 2. Pelvic MRI showing a 26-mm perineal injury accompanied by associated soft tissue disruption
Figure 3
Figure 3. Perineal laceration with measurement markings following trauma. The green arrow indicates laceration, and the blue arrow indicates repair with Prolene
See this image and copyright information in PMC

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