Occult rectal perforation in a major pelvic fracture

Major pelvic fractures are a common sequela of motor vehicle accidents. Hemorrhage, sepsis, and laceration of viscera contribute significantly to the patient’s morbidity and mortality and should be promptly evaluated. Early use of computed tomography is helpful in establishing the integrity of viscera and tissue planes. Knowledge of the retroperitoneal pathways of spread of disease may significantly accelerate primary repairs and subsequent early return of function. A case illustrating these concepts is presented.