PT  - JOURNAL ARTICLE
AU  - Adeola Awomolo
AU  - Danielle Hardman
AU  - Adetola Louis-Jacques
TI  - Obstetric rectal laceration in the absence of an anal sphincter injury
AID  - 10.1136/bcr-2021-243296
DP  - 2021 Aug 01
TA  - BMJ Case Reports
PG  - e243296
VI  - 14
IP  - 8
4099  - http://casereports.bmj.com/content/14/8/e243296.short
4100  - http://casereports.bmj.com/content/14/8/e243296.full
SO  - BMJ Case Reports2021 Aug 01; 14
AB  - Rectal laceration in the absence of concurrent anal sphincter injury at the time of parturition is not a frequently reported finding. This rarely encountered injury is also referred to as a buttonhole injury. It is a disruption of the vaginal and rectal tissue with resultant disruption of the anal epithelium in the setting of an intact external anal sphincter. A 30-year-old gravida 1 para 0 at 39 weeks presented for induction of labour due to chronic hypertension. During her labour course, she developed with superimposed preeclampsia with severe features and magnesium sulfate was initiated. She underwent a spontaneous vaginal delivery of an infant weighing 3840 g. Following delivery, stool was visualised in the vagina. A rectal examination revealed a rectovaginal defect separate from the second-degree perineal laceration, which extended proximally to the cervix. The anal sphincter was noted to be intact with good tone. Both defects were repaired, and she had an uncomplicated recovery.