Use of combined access in treatment penetrating peritoneal wound in 10-year-old girl

Background. Combined penetrating injuries of the perineum, rectum, and vagina in children are rare, and there is no unified algorithm for their surgical treatment. Clinical case. The case of a 10-year-old girl with a penetrating injury to the perineum, accompanied by damage to the anterior wall of the rectum and the posterior wall/vault of the vagina with penetration into the abdominal cavity, is presented. Diagnostic laparoscopy, laparoscopic suturing of the vaginal injury, transvaginal correction, and primary suturing of the rectal defect without forming a disconnecting colostomy were performed. The postoperative period proceeded favorably. No dysfunction of the intestines, urinary tract, or reproductive system was detected during a 4-year follow-up. Conclusion. A combined laparoscopic, transvaginal, and transanal approach can provide a comprehensive assessment of the injuries and simultaneous reconstruction in carefully selected cases of combined penetrating injuries to the perineum in children.