case_images: PMC7224970_01
case_images: High-pressure distal colostogram lateral views (case 1). (
  a
  ) Opacification of distal colon with convexity of distal rectal pouch. No rectourinary fistula is demonstrated. (
  b
  ) Rectal pouch perforation with extraperitoneal contrast extravasation. (
  c
  ) Progression of the extraperitoneal contrast extravasation. (
  d
  ) progression of the contrast extravasation, extending into the peritoneum.
case_images: 10-1055-s-0040-1709140-i190458cr-1.jpg
case_images: PMC7224970_01_10-1055-s-0040-1709140-i190458cr-1.jpg
case_images: FI190458cr-1
case_images: The contrast study was complicated by a rectal perforation with initial extraperitoneal contrast leak and progressive contrast spillage into the peritoneal space ( Figs. 1 and 2 ).
case_images: Case 1. High-pressure distal colostogram anteroposterior view showing the massive intraperitoneal extravasation of Urografin.
case_images: 10-1055-s-0040-1709140-i190458cr-2.jpg
case_images: PMC7224970_01_10-1055-s-0040-1709140-i190458cr-2.jpg
case_images: FI190458cr-2
case_images: The contrast study was complicated by a rectal perforation with initial extraperitoneal contrast leak and progressive contrast spillage into the peritoneal space ( Figs. 1 and 2 ).
case_images: PMC7224970_02
case_images: PMC7224970_03
case_images: High-pressure distal colostogram (case 2). (
  a
  ) Lateral view: opacification of the distal colon with convexity of distal rectal pouch. No rectourinary fistula is demonstrated. (
  b
  ) Rectal pouch perforation with contrast extravasation into the perineum. (
  c
  ) Lateral view: progressive perineal contrast extravasation extending into the scrotum. (
  d
  ) Anteroposterior view: progressive perineal contrast extravasation extending into the scrotum.
case_images: 10-1055-s-0040-1709140-i190458cr-3.jpg
case_images: PMC7224970_03_10-1055-s-0040-1709140-i190458cr-3.jpg
case_images: FI190458cr-3
case_images: The contrast study was complicated by distal rectal pouch perforation and extravasation of contrast into the perineum and scrotum ( Fig. 3 ).
case_images: Case 2. Features of the perineum and scrotum immediately after the perforation occurred.
case_images: 10-1055-s-0040-1709140-i190458cr-4.jpg
case_images: PMC7224970_03_10-1055-s-0040-1709140-i190458cr-4.jpg
case_images: FI190458cr-4
case_images: Necrotizing fasciitis was macroscopically confirmed, and an extensive scrotal and perineal debridement was performed ( Fig. 4 ).
case_images: Case 2. Features of the perineum and scrotum 24 hours after the perforation occurred with macroscopic necrotizing fasciitis.
case_images: 10-1055-s-0040-1709140-i190458cr-5.jpg
case_images: PMC7224970_03_10-1055-s-0040-1709140-i190458cr-5.jpg
case_images: FI190458cr-5
case_images: Two days later, a second debridement was performed ( Fig. 5 ).
case_images: Case 2. Left: features of the perineum and scrotum 72 hours after the extraperitoneal rectal perforation (after the second debridement). Right: perineum and scrotum 6 weeks after the perforation.
case_images: 10-1055-s-0040-1709140-i190458cr-6.jpg
case_images: PMC7224970_03_10-1055-s-0040-1709140-i190458cr-6.jpg
case_images: FI190458cr-6
case_images: Six weeks following the rectal perforation, the child underwent an examination under anesthesia, which indicated scrotal wound healing and a rectoperineal fistula anterior to the muscle complex that could fit a 4-mm Hegar dilator ( Fig. 6 ).