Endoluminal Vacuum-Assisted Closure for Penetrating Rectal Injury in a Pediatric Patient

Purpose: Endoluminal Vacuum-assisted closure therapy (EVT) has been employed to assist in closure of rectal defects with high success rates. Most of the literature is focused on the use of EVT after anastomotic leaks, and has been limited in the pediatric population to esophageal defects. We describe a case report of the successful use of EVT in a penetrating rectal injury in a pediatric patient. Results: The patient is a 15-year-old male who suffered a traumatic 6 cm full thickness penetrating anorectal injury, initially treated with fecal diversion, pre-sacral drainage, and distal rectal washout. He developed worsening pre-sacral abscess and was subsequently treated with EVT for 10 weeks with successful closure of the defect. Upon completion, he had restoration of intestinal continuity and maintained fecal continence. Conclusions: EVT can be used to successfully manage penetrating rectal injuries in the pediatric population. This can avoid extensive surgical resection or permanent ostomy and help control sepsis.