World Journal of Colorectal Surgery

Traumatic cloaca is a devastating condition usually secondary to massive obstetric injury with perineal diastasis. Primary repairs are rarely performed and often fail when performed due to hematoma, infection or excessive tissue tension. Methods: We present a case of immediate repair of traumatic cloaca in a 22 year old female with a history of self inflicted traumatic cloaca sustained 8 hours prior to presentation. A detailed examination revealed complete disruption of the perineal body, anterior sphincter complex and rectovaginal septum. Results: The patient underwent a successful immediate layered repair with anterior overlapping sphincteroplasty and biologic mesh reinforcement. Fecal diversion was not performed. She was fully continent at 4 weeks with no functional sequelae. Conclusions: To our knowledge, this is the first reported case of such an unusual mode of injury and its successful primary repair thereof with novel use of a biologic mesh for reinforcement. Primary repair of obstetric trauma resulting in cloacal injuries can be performed using our technique