PERFORATED WOUND OF THE RECTUM INTO THE POUCH OF DOUGLAS

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Abstract
An unusual case of impalement by the handle of a mop has been described in detail; the instrument entered the rectum through the perineum and penetrated the pouch of Douglas. Fulminating peritonitis developed rapidly. The patient was operated upon four hours after the accident occurred; the postoperative convalescence was complicated by pneumonia and serum-disease; recovery followed. Injuries of this type are rare. Their incidence, etiology, classification, diagnosis, treatment, and mortality have been discussed briefly. Intraperitoneal impalement with injury of abdominal viscera is a very serious type of wound and carries an exceedingly high mortality. Peritonitis is responsible for the vast majority of deaths.

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