Anorectal injury related to a personal watercraft: a case report and literature review

Abstract Background Douche injury is a rare consequence of water recreation activities. Generally, this type of trauma occurs when people fall into the water in a sitting position during high-speed activities such as using a personal watercraft (PWC). Here, we report a rare case of anorectal injury...

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Main Authors: Kaoru Katano, Yuichiro Furutani, Chikashi Hiranuma, Masakazu Hattori, Kenji Doden, Yasuo Hashidume
Format: Article
Language:English
Published: Japan Surgical Society 2020-09-01
Series:Surgical Case Reports
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Online Access:http://link.springer.com/article/10.1186/s40792-020-00993-9
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author Kaoru Katano
Yuichiro Furutani
Chikashi Hiranuma
Masakazu Hattori
Kenji Doden
Yasuo Hashidume
author_facet Kaoru Katano
Yuichiro Furutani
Chikashi Hiranuma
Masakazu Hattori
Kenji Doden
Yasuo Hashidume
author_sort Kaoru Katano
collection DOAJ
description Abstract Background Douche injury is a rare consequence of water recreation activities. Generally, this type of trauma occurs when people fall into the water in a sitting position during high-speed activities such as using a personal watercraft (PWC). Here, we report a rare case of anorectal injury caused by water jets from a PWC during sudden acceleration from rest. Case presentation A 21-year-old male passenger on a PWC fell off backward from the rear seat when the craft suddenly accelerated. He fell into the water in a supine position with his legs open, and the water jets of the PWC struck his perineum directly. Thereafter, bleeding from the anus was seen, and he was transferred to our hospital. On physical examination, there was a deep laceration interrupting the external anal sphincter in the posterior rectal wall. Abdominal computed tomography revealed a full-layer perforation of the posterior rectal wall and leakage of feces into the extraperitoneal space, but intraperitoneal free air was not seen. Laparoscopic sigmoid loop colostomy and primary suturing of the sphincter and mucosa were performed. He did not have any complications and was discharged from our hospital 16 days after the surgery. His anal function was almost perfectly preserved, and his diverting colostomy was closed 4 months later. Conclusion Anorectal injuries related to PWCs can occur not only while traveling at high speeds, but also when suddenly accelerating from rest. A diverting colostomy should be performed for this type of trauma. In these trauma cases, clinicians must suspect complex and life-threatening anorectal injuries early.
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spelling doaj-art-99a9142f02bf436ebb2fe7a3986b2b632025-08-20T03:33:46ZengJapan Surgical SocietySurgical Case Reports2198-77932020-09-01611610.1186/s40792-020-00993-9Anorectal injury related to a personal watercraft: a case report and literature reviewKaoru Katano0Yuichiro Furutani1Chikashi Hiranuma2Masakazu Hattori3Kenji Doden4Yasuo Hashidume5Department of Surgery, Fukui Prefectural HospitalDepartment of Surgery, Fukui Prefectural HospitalDepartment of Surgery, Fukui Prefectural HospitalDepartment of Surgery, Fukui Prefectural HospitalDepartment of Surgery, Fukui Prefectural HospitalDepartment of Surgery, Fukui Prefectural HospitalAbstract Background Douche injury is a rare consequence of water recreation activities. Generally, this type of trauma occurs when people fall into the water in a sitting position during high-speed activities such as using a personal watercraft (PWC). Here, we report a rare case of anorectal injury caused by water jets from a PWC during sudden acceleration from rest. Case presentation A 21-year-old male passenger on a PWC fell off backward from the rear seat when the craft suddenly accelerated. He fell into the water in a supine position with his legs open, and the water jets of the PWC struck his perineum directly. Thereafter, bleeding from the anus was seen, and he was transferred to our hospital. On physical examination, there was a deep laceration interrupting the external anal sphincter in the posterior rectal wall. Abdominal computed tomography revealed a full-layer perforation of the posterior rectal wall and leakage of feces into the extraperitoneal space, but intraperitoneal free air was not seen. Laparoscopic sigmoid loop colostomy and primary suturing of the sphincter and mucosa were performed. He did not have any complications and was discharged from our hospital 16 days after the surgery. His anal function was almost perfectly preserved, and his diverting colostomy was closed 4 months later. Conclusion Anorectal injuries related to PWCs can occur not only while traveling at high speeds, but also when suddenly accelerating from rest. A diverting colostomy should be performed for this type of trauma. In these trauma cases, clinicians must suspect complex and life-threatening anorectal injuries early.http://link.springer.com/article/10.1186/s40792-020-00993-9Anorectal injuryPersonal watercraftStrategy
spellingShingle Kaoru Katano
Yuichiro Furutani
Chikashi Hiranuma
Masakazu Hattori
Kenji Doden
Yasuo Hashidume
Anorectal injury related to a personal watercraft: a case report and literature review
Surgical Case Reports
Anorectal injury
Personal watercraft
Strategy
title Anorectal injury related to a personal watercraft: a case report and literature review
title_full Anorectal injury related to a personal watercraft: a case report and literature review
title_fullStr Anorectal injury related to a personal watercraft: a case report and literature review
title_full_unstemmed Anorectal injury related to a personal watercraft: a case report and literature review
title_short Anorectal injury related to a personal watercraft: a case report and literature review
title_sort anorectal injury related to a personal watercraft a case report and literature review
topic Anorectal injury
Personal watercraft
Strategy
url http://link.springer.com/article/10.1186/s40792-020-00993-9
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AT yuichirofurutani anorectalinjuryrelatedtoapersonalwatercraftacasereportandliteraturereview
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AT masakazuhattori anorectalinjuryrelatedtoapersonalwatercraftacasereportandliteraturereview
AT kenjidoden anorectalinjuryrelatedtoapersonalwatercraftacasereportandliteraturereview
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