Complex perineal trauma in a polytraumatized patient: a diagnostic and therapeutic challenge for the surgeon. Case report

Abstract

The perineum is a diamond-shaped region composed of soft tissue that, inferiorly, seals the outlet of the pelvic cavity. The boundaries of this region include the pubic arch anteriorly, the ischioubical rami and the ischial tuberosity laterally, the sacrotuberous ligaments posterolaterally, and the coccyx posteriorly. In this way, the perineum is divided into 2 segments: the urogenital triangle anteriorly and the anal triangle posteriorly.  A literature review was conducted on various articles that address the subject from different perspectives (diagnostic, therapeutic, epidemiological) to complement the report of our experience with a case of a female patient who suffered complex perineal trauma. The management of these injuries entails significant challenges for the general surgeon, given their low incidence and the complexity of their diagnosis. It is extremely important to adhere to assessment and management protocols to avoid overlooking unnoticed injuries. It is equally important to understand that the real challenge lies in ensuring proper progress, given that the complication rate from infectious processes is considerably high when present in an area with constant sources of contamination