Postpartum Traumatic Rectal Tear After Normal Vaginal Delivery with an Intact Anal Sphincter

Abstract

Abstract

Background: A case of “buttonhole” rectal tear after normal delivery is reported. “Buttonhole” injuries are those in which the vaginal and rectal walls are torn, causing disruption of the anal epithelium, while the external anal sphincter remains intact. Case : A 25-year-old gravida 1, para 1 who had had a normal vaginal labor 27 days earlier, was admitted, and after thorough examination, this type of injury was found. Management of the case is extensively described and a concise review of the relevant literature is presented. Results: The postoperative period was uneventful. At her next scheduled appointment, physical examination was negative for any fistula formation or surgical injuries. Conclusions: This report provides information about appropriate methods of surgical treatment and emphasizes the need for better education in cases of perineal lacerations by gynecologists. (J GYNECOL SURG 28:176)