{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T00:07:10Z","timestamp":1788826030735,"version":"build-2803163510"},"reference-count":9,"publisher":"Georg Thieme Verlag KG","issue":"01","license":[{"start":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T00:00:00Z","timestamp":1788134400000},"content-version":"vor","delay-in-days":242,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["European J Pediatr Surg Rep."],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:p>Blast injuries involving the perineum are rare, particularly in the pediatric population, and may result in complex combined anorectal and genitourinary trauma. These injuries present major reconstructive challenges because of contamination risk, infection, and possible long-term functional impairment. Management has traditionally favored staged procedures with fecal diversion, especially in severe anorectal and rectovaginal injuries.<\/jats:p>\n                  <jats:p>We report here the case of a 10-year-old girl who sustained a severe blast injury resulting in a large perineal defect involving the anal canal, perineal body, and posterior vaginal wall. The patient underwent a successful single-stage reconstruction surgery consisting of posterior vaginal wall repair, perineal body reconstruction, and anterior anorectal wall repair without diverting colostomy. She tolerated the procedure well and remained hemodynamically stable throughout the perioperative course. At 8-week follow-up, the reconstructed tissues had completely healed, with preserved fecal continence and no pain, although residual scarring from the initial injury was noted.<\/jats:p>\n                  <jats:p>This case adds to the limited pediatric literature on severe perineal trauma and suggests that, in select hemodynamically stable patients with extraperitoneal injury and viable tissues, primary layered reconstruction without fecal diversion may be feasible.<\/jats:p>","DOI":"10.1055\/a-2948-3623","type":"journal-article","created":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T23:02:13Z","timestamp":1788217333000},"page":"e50-e54","source":"Crossref","is-referenced-by-count":0,"title":["Primary Reconstruction of Combined Anorectal and Vaginal Blast Injury in a Pediatric Patient without Fecal Diversion: A Case Report"],"prefix":"10.1055","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-9690-496X","authenticated-orcid":false,"given":"Omar","family":"Alameddine","sequence":"additional","affiliation":[{"name":"American University of Beirut Medical Center, Lebanon","place":["Beirut"],"department":["Department of Obstetrics and Gynecology"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasmina","family":"Salam","sequence":"additional","affiliation":[{"name":"American University of Beirut Medical Center, Lebanon","place":["Beirut"],"department":["Department of Obstetrics and Gynecology"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"George","family":"Hatoum","sequence":"additional","affiliation":[{"name":"American University of Beirut Medical Center, Lebanon","place":["Beirut"],"department":["Department of Obstetrics and Gynecology"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nathalie","family":"Chamseddine","sequence":"additional","affiliation":[{"name":"American University of Beirut Medical Center, Lebanon","place":["Beirut"],"department":["Department of Obstetrics and Gynecology"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samir","family":"Akel","sequence":"additional","affiliation":[{"name":"American University of Beirut Medical Center, Lebanon","place":["Beirut"],"department":["Department of Surgery"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2026,9,7]]},"reference":[{"key":"ref1","doi-asserted-by":"crossref","first-page":"388","DOI":"10.1007\/s003830000347","article-title":"Anorectal injuries in children","volume":"16","author":"E A Ameh","year":"2000","journal-title":"Pediatr Surg Int"},{"issue":"10","key":"ref2","first-page":"192","article-title":"Severe blunt extraperitoneal rectal trauma in a 6-year-old female: case report and review of the literature","volume":"3","author":"A Jonuzi","year":"2021","journal-title":"East Afr Scholars J Med Surg"},{"issue":"02","key":"ref3","doi-asserted-by":"crossref","first-page":"hcae175.724","DOI":"10.1093\/qjmed\/hcae175.724","article-title":"Outcome of peri-anal injury management in children and adolescents","volume":"117","author":"M AM Fahmy","year":"2024","journal-title":"QJM"},{"issue":"11","key":"ref4","first-page":"889","article-title":"Rectovaginal injury in a young child. A case report","volume":"48","author":"J S Platt","year":"2003","journal-title":"J Reprod Med"},{"issue":"03","key":"ref5","doi-asserted-by":"crossref","first-page":"344","DOI":"10.30442\/ahr.0603-12-98","article-title":"Paediatric perineal injury following explosive blast: a case report","volume":"6","author":"N J Nwashilli","year":"2020","journal-title":"Ann Health Res"},{"issue":"11","key":"ref6","doi-asserted-by":"crossref","first-page":"1071","DOI":"10.1007\/s00383-007-1996-5","article-title":"Outcomes and management of rectal injuries in children","volume":"23","author":"A Bonnard","year":"2007","journal-title":"Pediatr Surg Int"},{"issue":"04","key":"ref7","doi-asserted-by":"crossref","first-page":"249","DOI":"10.1055\/s-2003-42233","article-title":"Management of anorectal injuries in children: an eighteen-year experience","volume":"13","author":"H Ozt\u00fcrk","year":"2003","journal-title":"Eur J Pediatr Surg"},{"issue":"01","key":"ref8","doi-asserted-by":"crossref","first-page":"65","DOI":"10.4103\/jiaps.JIAPS_322_20","article-title":"The management of perineal trauma in children","volume":"27","author":"D A Manjunath","year":"2022","journal-title":"J Indian Assoc Pediatr Surg"},{"key":"ref9","doi-asserted-by":"crossref","first-page":"107874","DOI":"10.1016\/j.ijscr.2023.107874","article-title":"Surgical management of traumatic perineal injury in female children: a report of two cases","volume":"103","author":"A O Oyinloye","year":"2023","journal-title":"Int J Surg Case Rep"}],"container-title":["European Journal of Pediatric Surgery Reports"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-2948-3623.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T23:11:07Z","timestamp":1788822667000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-2948-3623"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1]]},"references-count":9,"journal-issue":{"issue":"01","published-online":{"date-parts":[[2026,1,24]]},"published-print":{"date-parts":[[2026,1]]}},"URL":"https:\/\/doi.org\/10.1055\/a-2948-3623","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["2194-7619","2194-7627"],"issn-type":[{"value":"2194-7619","type":"print"},{"value":"2194-7627","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026,8,31]]},"published":{"date-parts":[[2026,1]]}}}