Ann Coloproctol.  2014 Feb;30(1):47-49. 10.3393/ac.2014.30.1.47.

Transanal Evisceration Caused by Rectal Laceration

• Martinez Perez A
• Torres Sanchez MT
• Richart Aznar JM
• Marti Martinez EM
• Martinez-Abad M

• KMID: 2134012
• DOI: http://doi.org/10.3393/ac.2014.30.1.47

Abstract

Transrectal evisceration caused by colorectal injury is an unusual entity. This pathology is more frequent in elderly patients and it is usually produced spontaneously. Rectal prolapse is the principal predisposing factor. An 81-year-old woman was taken to the hospital presenting exit of intestinal loops through the anus. After first reanimation measures, an urgent surgery was indicated. We observed the absence of almost every small intestine loop in the abdominal cavity; these had been moved to the pelvis. After doing the reduction, a 3 to 4 cm linear craniocaudal perforation in upper rectum was objectified, and Hartmann's procedure was performed. We investigated and knew that she frequently manipulate herself to extract her faeces. The fast preoperative management avoided a fatal conclusion or an extensive intestinal resection. Reasons that make us consider rectal self-injury as the etiologic factor are explained.

Keyword

Rectum; Abdominal injuries; Intestinal perforation

MeSH Terms

Abdominal Cavity
Abdominal Injuries
Aged
Aged, 80 and over
Anal Canal
Causality
Female
Humans
Intestinal Perforation
Intestine, Small
Lacerations*
Pathology
Pelvis
Rectal Prolapse
Rectum