• Michelle V Vincent, Colin Abel, and Newton D Duncan.
• University Hospital of the West Indies, Mona, Kingston 7, Jamaica. michvincent@yahoo.com
• Pediatr. Surg. Int. 2012 Nov 1; 28 (11): 1101-7.

PurposeTo discuss the presentation, management and outcomes of penetrating anorectal injuries at the Bustamante Hospital for Children.MethodsA retrospective review over an 11-year period (January 2001-December 2011) was undertaken. The data analysed were extracted from patients' case notes which were pulled based on the hospital's admission database.ResultsOver the study period a total of 14 children presented with penetrating anorectal injuries. The medical records for one child were missing. The mean age at presentation was 6 years. Impalement by a metal spike was the mechanism of injury in 12 children, with one case of sexual assault. Three of the children had associated urogenital injuries. Ten rectal injuries were extraperitoneal. Five of the 13 cases (38 %) were managed with a colostomy-average time to closure was 6 months. There was one case of perineal wound infection and dehiscence. There was no mortality.ConclusionSelective fecal diversion in the form of a sigmoid loop colostomy is a safe and acceptable management option for children with penetrating anorectal injuries. The perineal wound itself can be closed primarily except in cases of delayed presentation.

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