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Session: ePoster: Benign Anorectal 1 (Sun8)

EP248 - Traumatic Tear: A Case of an Anterior and Posterior Wall Rectal Tear secondary to a Jet Ski Accident

Sunday, May 11, 2025
9:44 AM – 9:49 AM PT
Location: Monitor 3, Sails Pavilion, Upper Level

    ePoster Presenter(s)

  • Karri E. Hester, MD, MS (she/her/hers)

    Resident Surgeon
    Danbury Hospital, Department of Surgery
    Danbury Hospital, Department of General Surgery
    Danbury, CT, United States

    All of the relevant financial relationships listed below have been mitigated.
    This individual has no financial relationships with ineligible companies.

    • Author(s)

  • TR

    Trevor Roush, MD

    General Surgery Resident
    Danbury Hospital, Department of Surgery
    Danbury, Connecticut, United States

    Disclosure information not submitted.

    • Senior Author(s)

  • XD

    Xiang Dong, MD, FACS

    Chief of Surgical Oncology
    Danbury Hospital, Department of Surgery
    Danbury, Connecticut, United States

    All of the relevant financial relationships listed below have been mitigated.
    This individual has no financial relationships with ineligible companies.

All of the relevant financial relationships listed below have been mitigated.
Karri E. Hester, MD, MS: This individual has no financial relationships with ineligible companies.
Xiang Dong, MD, FACS: This individual has no financial relationships with ineligible companies.
Image or Table (Do Not add text here):

Purpose/Background: Jet Ski-related traumatic rectal injuries have been documented in the literature over the last 30-40 years. They are typically seen while traveling at higher speeds with the injury being a result of falling off the Jet ski and the resultant hydrostatic pressure in the anorectal area. These injuries are uncommon but do pose significant damage as well as difficulty in their repair. In our case, we present an interesting case of both an anterior and posterior rectal wall perforation.

Methods/Interventions: Our patient is a 19-year-old female who presented after a jet ski accident where she fell off the back of a Jet ski and began to experience severe abdominal pain and bright red blood per rectum. She underwent a trauma work-up including a CT of the Abdomen and Pelvis with intravenous contrast which demonstrated significant pneumoperitoneum and severe thickening of the rectum with discontinuity of the anterior wall of the rectum. She was taken emergently to the operating room and underwent an exploratory laparotomy and a Hartmann’s procedure. We found that she had a 5cm hole in the anterior surface of the rectum in the upper rectum with free perforation into the abdominal cavity. She had fecal peritonitis from the anterior wall upper rectal perforation. In addition, we performed a flexible sigmoidoscopy after temporary closure of the anterior perforation. We found that she also had a large full-thickness tear on the posterior wall of the mid to lower rectum. This was left alone as it was contained within the peri-rectal tissue. We also excised the upper rectum that was perforated and necrotic.

Results/Outcomes: Her post-operative course was largely uncomplicated. She was discharged approximately 10 days after her admission in stable condition. She underwent repeat imaging approximately 1 month after discharge that still demonstrated an anterior wall defect but no appreciable defect of the posterior wall. She is currently pending repeat imaging and future colostomy reversal.

Conclusion/Discussion: Anorectal trauma resulting from Jet ski injuries is rare but significant. Prompt identification and suspicion of the injury is crucial to maximizing the best possible outcome. Additionally, it is crucial to adequately assess the extent of the injury both intra-abdominally as well as intraluminally as was done in our case and allowed us to successfully identify both anterior and posterior wall tear. Moreover, end colostomy creation remains integral to the success of any anorectal repair and healing.