Rectal Perforation after Anal Intercourse

Introduction: Injuries during intercourse can range from superficial vaginal bleeding to severe ones that can lead to recto - vaginal fistulas and hemorrhage, which are usually related with rape and foreign body insertion. Presentation of case: We report a 24-year old female with history old chronic constipation, who presented in our emergency department with acute abdominal pain 24 hours after consensual anal intercourse, while denying any sex toy , fisting or foreign body insertion. In surgery a Hartman procedure was performed, due to fecal peritonitis from a large rectal tear in the upper third of the rectum. Discussion: The unique feature of this case is that the post coitus tear of the rectum caused by anal intercourse between two heterosexual adults resulted in intraperitoneal peritonitis, while the anal sphincters were left intact. Conclusion: Sexual related traumas are taboo subjects as well as the cause of embarrassment and distress to most patients. It is vital that they are treated in a professional manner that respects their dignity, and that clinical care is aimed at correcting the situation as safely and painlessly as possible.