{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,29]],"date-time":"2026-03-29T11:35:20Z","timestamp":1774784120243,"version":"3.50.1"},"reference-count":6,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2026,3,29]],"date-time":"2026-03-29T00:00:00Z","timestamp":1774742400000},"content-version":"vor","delay-in-days":28,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,3,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Extraperitoneal rectal injuries are uncommon and traditionally managed with fecal diversion, particularly when sphincter involvement is present. We report a case of a 26-year-old male who presented 5\u00a0days after a low-energy rectal impalement caused by a collapsed metal chair, with persistent rectal pain, fecal incontinence, and purulent drainage following initial repair at an outside institution. Examination under anesthesia revealed a posterior rectal laceration extending 6\u00a0cm from the anal verge, involving ~25% of the rectal circumference with disruption of the internal anal sphincter. After thorough debridement, an overlapping sphincteroplasty was performed without fecal diversion due to viable tissue, minimal contamination, preserved external sphincter function, and hemodynamic stability. The patient recovered uneventfully. This case highlights the feasibility of selective non-diverted management of extraperitoneal rectal trauma with sphincter involvement in carefully selected patients.<\/jats:p>","DOI":"10.1093\/jscr\/rjag200","type":"journal-article","created":{"date-parts":[[2026,3,29]],"date-time":"2026-03-29T09:38:00Z","timestamp":1774777080000},"source":"Crossref","is-referenced-by-count":0,"title":["Metallica chair does not spare the sphincter: successful operative reconstruction of an extraperitoneal rectal injury with sphincter involvement"],"prefix":"10.1093","volume":"2026","author":[{"given":"Clement","family":"Rajakumar","sequence":"first","affiliation":[{"name":"Department of Surgery, Jersey Shore University Medical Center , 1945 Route 33, Neptune, NJ 07753, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jainika","family":"Patel","sequence":"additional","affiliation":[{"name":"St. George\u2019s University School of Medicine , St. George\u2019s ,","place":["Grenada"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Khea","family":"Tan","sequence":"additional","affiliation":[{"name":"Department of Surgery, Jersey Shore University Medical Center , 1945 Route 33, Neptune, NJ 07753, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Glenn S","family":"Parker","sequence":"additional","affiliation":[{"name":"Department of Surgery, Jersey Shore University Medical Center , 1945 Route 33, Neptune, NJ 07753, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rachel","family":"Masia","sequence":"additional","affiliation":[{"name":"Department of Surgery, Jersey Shore University Medical Center , 1945 Route 33, Neptune, NJ 07753, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2026,3,29]]},"reference":[{"key":"2026032905375229200_ref1","volume-title":"StatPearls","author":"McMahon","year":"2025"},{"key":"2026032905375229200_ref2","doi-asserted-by":"publisher","first-page":"1133","DOI":"10.1016\/j.injury.2017.03.002","article-title":"The management of penetrating rectal and anal trauma: a systematic review","volume":"48","author":"Ahern","year":"2017","journal-title":"Injury"},{"key":"2026032905375229200_ref3","doi-asserted-by":"publisher","first-page":"1245","DOI":"10.1097\/DCR.0000000000001221","article-title":"Management of trauma to the rectum and anus","volume":"61","author":"Lee","year":"2018","journal-title":"Dis Colon Rectum"},{"key":"2026032905375229200_ref4","doi-asserted-by":"publisher","first-page":"546","DOI":"10.1097\/TA.0000000000000953","article-title":"Management of penetrating extraperitoneal rectal injuries: an Eastern Association for the Surgery of Trauma practice management guideline","volume":"80","author":"Bosarge","year":"2016","journal-title":"J Trauma Acute Care Surg"},{"key":"2026032905375229200_ref5","doi-asserted-by":"publisher","first-page":"e33","DOI":"10.1097\/DCR.0000000000001380","article-title":"Traumatic injury of the colon and rectum: the evidence vs dogma","volume":"62","author":"Steele","year":"2019","journal-title":"Dis Colon Rectum"},{"key":"2026032905375229200_ref6","doi-asserted-by":"publisher","first-page":"656","DOI":"10.1097\/00005373-199810000-00002","article-title":"The role of presacral drainage in the management of penetrating rectal injuries","volume":"45","author":"Gonzalez","year":"1998","journal-title":"J Trauma"}],"container-title":["Journal of Surgical Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/jscr\/article-pdf\/2026\/3\/rjag200\/67636838\/rjag200.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/jscr\/article-pdf\/2026\/3\/rjag200\/67636838\/rjag200.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,29]],"date-time":"2026-03-29T09:38:01Z","timestamp":1774777081000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jscr\/article\/doi\/10.1093\/jscr\/rjag200\/8555562"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3]]},"references-count":6,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2026,3,6]]}},"URL":"https:\/\/doi.org\/10.1093\/jscr\/rjag200","relation":{},"ISSN":["2042-8812"],"issn-type":[{"value":"2042-8812","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026,3]]},"published":{"date-parts":[[2026,3]]},"article-number":"rjag200"}}