Post-traumatic recto-spinal fistula

Acquired recto-spinal fistula has been described elsewhere as a rare compli cation of colorectal malignancy and Crohn's enterocolitis. We treated a you ng man who developed a recto-spinal fistula as a result of a high fall inju ry. The patient presented with meningeal signs, sepsis and perianal lacerat ion. Computerized axial tomography revealed air in the supersellar cistern. Gastrografin enema showed that contrast material was leaking from the rect um into the spinal canal. Surgical management included a diverting sigmoid colostomy, sacral bone curettage and wide presacral drainage. To the best o f our knowledge, rectospinal fistula of traumatic origin has not been previ ously reported in the English literature.