Penetrating rectal injuries themselves are associated with a 39–47% incidence of GU injury with the bladder being most frequently injured. Debridement of necrotic rectum with primary repair, proximal diversion, and the placement of an omentum pedicle flap between the rectum and GU injury have been recommended especially in cases of combined posterior bladder and anterior rectal injuries. High rates (24%) of rectovesical and rectourethral fistula are associated with combined GU and rectal injuries. We present a case with mid rectal injury with posterior and anterior urinary bladder wall injury with injury to right ureter managed by single stage resection of injured rectum with primary rectorectal anastomoses, repair of urinary bladder wall injury with right ureteric reimplantation without proximal diversion without any postoperative complications, the first case report of such management of rectovesical injury in the world.
Sisodiya R* and Joshi N