ABSTRACT

Introduction:

Perineal hernia is un uncommon and challenging surgical condition characterized by posterior dislocation of the rectum or other intestinal tract through a weak or damaged pelvic floor, causing obstructed defecation and requiring surgical repair by an experienced surgical team.

Methods:

Herein we report the case of a posterior perineal hernia (posterior rectocele) occurred in a patient after surgical drainage of a perineal abscess and causing severe obstructed defecation. After diagnostic work-up, including dynamic defecography and anorectal manometry, the perineal defect was repaired by means of a biological mesh of bovine pericardium.

Results:

The postoperative course was uneventful and the medium term outcome, evaluated by a dedicated severity of disease and quality of life questionnaires, was significantly improved.

Comment:

Use of biological mesh can be useful in the repair of difficult cases of posterior perineal hernia where the risk of infection and direct contact with the viscera makes other choices more risky.