Survey forms were sent to all members of the Coloproctology Section of the Royal Society of Medicine and the American Society of Colon and Rectal Surgeons to obtain their opinions of the availability, actual use, and perceived helpfulness of different methods for the evaluation of the physiology of the colon and rectum. Responses revealed a similarity in age and practice patterns in both groups. Of the 19 methods surveyed, greater than 90 percent of respondents in both groups rely on three traditional methods of patient evaluation: patient history, digital examination, and sigmoidoscopy. Four other methods have gained acceptance by the majority of respondents in both groups: colon transit studies, defecography, perfused-catheter manometry, and rectal compliance. The three methods ranked lowest in availability, actual use, and helpfulness by both groups were single-fiber electromyography, use of a perineometer, and evoked potential studies. Our study provides a baseline for future surveys on the investigative efforts of physicians studying the physiology of the colon, rectum, and anus.

Small bowel evisceration through the vagina is a rare condition, which tends to affect post-menopausal women who have undergone vaginal hysterectomy. It is a surgical emergency with a favourable outcome if diagnosed and treated in a timely fashion. Delay in diagnosis can precipitate infarction of small bowel loops with associated morbidity and mortality. Treatment involves laparotomy, reduction of the incarcerated loops, plus/minus small bowel resection) and repair of the vaginal rupture. The purpose of this paper is to report a case of small bowel evisceration through the vagina, to review the literature pertaining to this topic and to raise awareness of this condition in the general surgical community.