What Causes Pain And Vaginal Bleeding Post Anal Intercourse?

I am an RN doing triage in an internal medicine clinic today a female patient called with complaints of pain and bleeding following anal intercourse. She had no history of hemorrhoids,not a large amount of bleeding but moderate to severe pain. I scheduled her for an appointment tomorrow but I am concerned that she could have a perforated bowel I did advise ED if bleeding or pain increased this evening . Should I be worried about a perforation and what would the symptoms be?