Traumatic rectovesical perforation following fall injury: a rare case report

Abstract

Rectovesical perforation is an extremely rare but serious consequence of pelvic trauma, often overlooked in blunt injuries. We describe the case of a 25-year-old male construction worker who sustained traumatic rectovesical perforation after a fall onto a sharp object, presenting with hematuria, per rectal bleeding and urinary retention. Contrast-enhanced CT including CT cystography revealed extraperitoneal bladder rupture with extravasation into the rectum. Surgical management involved repair of bladder and rectal injuries, with both urinary (suprapubic + transurethral catheters) and fecal (loop sigmoid colostomy) diversion. Postoperative recovery was largely uneventful, with a superficial wound infection managed conservatively. The colostomy was reversed at five months, and the patient remains well at follow-up. This case underscores the importance of prompt diagnosis via CT cystography and a combined surgical approach with adequate diversion to achieve favorable outcomes.