Report of an unusual cast of perineal burn leading to anal sphincter dysfunction with fecal incontinence due to formation of an annular scar around anus

ABSTRACT

Isolated deep bum of perineal area is rare and usually occurs in cases with extensive bum. The etiology of this kind of bum may be of thermal, chemical or electrical origin. Treatment in most cases is conservative and surgical intervention rarely required. Isolated deep bum of perineal area has been reported in some special circumstances such as falling into furnace or pots containing hot fluids and sitting on exhaust pipe of vehicles; but no dysfunction of anal sphincter alter formation of perineal annular scar had been detected. Our objective is to focus on particular cases of perineal burn and its complications. A 12 years old Afghan boy with history of previous burn of perincal area at the age of 6 months, due to falling into boiled water, referred to Tohid Hospital with chief complaint of fecal incontinence. At that time the patient had been managed conservatively for his burn. As far as the patient's parents remember, he had been suffering from fecal incontinence since his childhood. In physical exam an annular scar around anus together with lack of sphincter tone were detected. By releasing the scar and use of skin graft, sphincter tone improved gradually. In special cases of isolated perineal deep burn, conservative management may lead to scarring and dysfunction of anal sphincter with fecal incontinence, imposing physical, social and psychological impacts specially on children. Proper and timely treatment is recommended to prevent this complication