J Korean Surg Soc.  2009 Mar;76(3):199-202. 10.4174/jkss.2009.76.3.199.

Transanal Small Bowel Eviceration due to Traumatic Rectal Perforation

• Kim HJ
• Hwang JS
• Jung SH
• Kang SH
• Kim JH

• KMID: 2096544
• DOI: http://doi.org/10.4174/jkss.2009.76.3.199

Abstract

Transanal small bowel evisceration by rectal perforation is a very rare presentation. It occurs spontaneously or in association with trauma. We experienced a 20-year-old female patient who had transanal evisceration of the small bowel due to blunt trauma. Operative findings showed traumatic rectal perforation and gangrenous change of the eviscerated small bowel due to tearing of the small bowel mesentery. Segmental resection of gangrenous small bowel with immediate anastomosis and Hartmann's procedure of rectal perforation were performed. After 9 months, reduction of sigmoid colostomy and colorectal anastomosis were performed. We report this rare case with a review of the literature.

Keyword

Transanal small bowel evisceration; Rectal perforation

MeSH Terms

Colon, Sigmoid
Colostomy
Female
Humans
Mesentery
Young Adult

Figure

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  Fig. 1 Transanal evisceration of small bowel.

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  Fig. 2 Fracture of pelvic bone.

Reference

1. Quraishi AH. Transanal evisceration of bowel loops due to blunt trauma. J Indian Assoc Pediatr Surg. 2007. 12:231–232.

2. Jeong J, Park JS, Byun CG, Yoon DS, Sohn SK, Lee YH, et al. Rupture of the rectosigmoid colon with evisceration of the small bowel through the anus. Yonsei Med J. 2000. 41:289–292.

3. Rechner P, Cogbill TH. Transanal small bowel evisceration from abdominal crush injury: case report and review of the literature. J Trauma. 2001. 50:934–936.

4. Zamir N, Sharif A, Soomro MA, Ahmed S, Akhtar J. Rectal perforation in children. J Coll Physicians Surg Pak. 2008. 18:66–67.

5. Ghosal SR, Bhattacharjee PK, Dey KK. Spontaneous rupture of rectum with prolapse of small gut through the anus - a case report. Indian J Surg. 2004. 66:291–293.

6. Bronkhorst MW, Wilde JC, Hamming JF, Heij HA. Anorectal impalement in a pediatric patient with transanal evisceration of small bowel. J Pediatr Surg. 2007. 42:E23–E25.

7. Shoab SS, Saravanan B, Neminathan S, Garsaa T. Thiersch repair of a spontaneous rupture of rectal prolapse with evisceration of small bowel through anus - a case report. Ann R Coll Surg Engl. 2007. 89:W6–W8.

8. Morris AM, Setty SP, Standage BA, Hansen PD. Acute transanal evisceration of the small bowel: report of a case and review of the literature. Dis Colon Rectum. 2003. 46:1280–1283.

9. Antony MT, Memon MA. Successful laparoscopic repair of spontaneous rectosigmoid rupture with an acute transanal small bowel evisceration. Surg Laparosc Endosc Percutan Tech. 2005. 15:172–173.

10. Wrobleski DE, Dailey TH. Spontaneous rupture of the distal colon with evisceration of small intestine through the anus: report of two cases and review of the literature. Dis Colon Rectum. 1979. 22:569–572.

11. Qureshi MI. Rectal tear causing prolapsed ileum after closed abdominal injury. Injury. 1977. 9:168–169.