Rectal injuries are not frequent in children. The authors present the case of an 11-year-old girl with a perforation of the rectum and vagina after falling on the steel rod of a bicycle pedal. Perineal incision with the widening of the vaginal entrance enabled good surgical access and careful reconstruction of the perforations without having to perform a colostomy. The injury healed without infectious complications, rectovaginal fistula or incontinence. Current opinions on the treatment of rectal injuries with individual access are discussed. Primary repair without faecal diversion can be considered in selected stabilized patients fewer than 6-8 hours from the time of injury without serious contamination, tissue devastation and associated injuries.