Jet Ski Hydrostatic Perineal Injuries from a Level I Trauma Experience

摘要

The popularity of personal watercrafts (PWCs) continues today despite abundant literature publicizing the dangers with these vehicles. A PWC is defined as any vessel that uses an inboard motor to power a water jet pump, is less than 16 feet in length, and is operated by a person in a sitting, kneeling, or standing position. The injuries sustained by the passenger onboard a PWC present a particular concern in the trauma population. A handful of cases have reported of hydrostatic injuries to the perineum caused by PWCs but only a couple of reports document simultaneous vaginal and rectal injuries from a Jet Ski accident. We present two cases of female passenger Jet Ski accidents presenting to our trauma bay over a 2-month span with rectal and vaginal injuries from hydrostatic forces suffered while falling off the back of the vehicle. We also present a review of the literature on management of injuries caused by the high pressure jets of water from PWCs. Case1 A 41-year-old female passenger was traveling on a Jet Ski at an unknown speed when she fell from the PWC suffering a hydrostatic injury to her perineum. The patient was brought into our trauma bay with abdominal pain and gross blood per rectum. A CT scan of her abdomen and pelvis revealed a rectal perforation and a questionable small bowel injury. The patient was taken to the operating room for exam under anesthesia and exploratory laparotomy. An exam with a rigid sigmoidoscope revealed four spiral rectal lacerations. Three of the four lacerations were amendable to primary repair utilizing a transanal approach. Next, a midline abdominal incision discovered pneumoperitoneum with an anterior rectal laceration extending 15 cm in length requiring primary repair. A diverting sigmoid end colostomy was performed because of the extent and mechanism of injury. Postoperatively she did well and was discharged on postoperative day 6. She underwent colostomy reversal five months later.