Obstetric rectal laceration in the absence of an anal sphincter injury. Issue 8 (6th August 2021)

• Record Type: Journal Article
• Authors: Awomolo, Adeola; Hardman, Danielle; Louis-Jacques, Adetola
• Is Part Of: BMJ case reports. Volume 14:Issue 8(2021)
• Publication Date: 2021-08-06
• Subjects: obstetrics and gynaecology -- pregnancy -- surgery; Medicine -- Case studies -- Periodicals; 610.5
• DOI: 10.1136/bcr-2021-243296
• Languages: English
• ISSNs: 1757-790X

Abstract

Abstract : Rectal laceration in the absence of concurrent anal sphincter injury at the time of parturition is not a frequently reported finding. This rarely encountered injury is also referred to as a buttonhole injury. It is a disruption of the vaginal and rectal tissue with resultant disruption of the anal epithelium in the setting of an intact external anal sphincter. A 30-year-old gravida 1 para 0 at 39 weeks presented for induction of labour due to chronic hypertension. During her labour course, she developed with superimposed preeclampsia with severe features and magnesium sulfate was initiated. She underwent a spontaneous vaginal delivery of an infant weighing 3840 g. Following delivery, stool was visualised in the vagina. A rectal examination revealed a rectovaginal defect separate from the second-degree perineal laceration, which extended proximally to the cervix. The anal sphincter was noted to be intact with good tone. Both defects were repaired, and she had an uncomplicated recovery.