Surgeon-performed sonographic findings in a traumatic trans-anal rectal perforation

Fikri M. Abu-Zidan, Mohamed I. Abusharia, Katharina Kessler

Research output: Contribution to journalArticlepeer-review

4 Citations (Scopus)


Early diagnosis and active management of trans-anal rectal injuries is essential for a favorable outcome. Intraperitoneal free air (IFA) is usually diagnosed by an erect Chest X-ray. Point-of-care ultrasound has been recently used to detect IFA. We report a 45-year-old male who presented to the Emergency Department with lower abdominal peritonitis. Surgeon-performed portable point-of-care ultrasound as an extension of the abdominal examination revealed an inflamed omentum with hypoechoic stranding, thickened non compressible small bowel, and free fluid in the pelvis. A transverse abdominal section of the right upper quadrant showed free intraperitoneal air. Rectal examination revealed a longitudinal rectal tear. Laparotomy has confirmed the sonographic findings. There was a 12 cm intraperitoneal tear of the anterior wall of the rectum which was necrotic. This case clearly demonstrates that portable point-of-care ultrasound gives very useful detailed information even when performed by a non radiologist. Surgeons should be encouraged to use point-of-care ultrasound after appropriate training.

Original languageEnglish
Article number26
JournalWorld Journal of Emergency Surgery
Issue number1
Publication statusPublished - Aug 12 2011


  • Free intraperitoneal air
  • Rectal trauma
  • Ultrasound

ASJC Scopus subject areas

  • Surgery
  • Emergency Medicine


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