Small bowel evisceration through the anus in rectal prolapse in an Indian male patient

Abstract

Evisceration of small intestine through anus is a rare presentation in emergency. We reported a case with long history of recurrent complete rectal prolapse presenting in emergency as small bowel protruding out through anal orifice. The small bowel herniated out from a spontaneous perforation in rectosigmoid. After resuscitation, emergency exploratory laparotomy was carried out and small bowel was reposited in the peritoneal cavity through the site of perforation by pulling and pushing maneuvere and the perforated segment of rectosigmoid was exteriorised as double barrel colostomy.

Transanal Evisceration of Small Bowel about One Case at the University Hospital Yalgado Ouédraogo of Ouagadougou

“…In all cases the surgical treatment obeyed the principles of digestive surgery. The prognosis of this disease is generally favorable as in our case and in several studies [3]- [5].…”

“…It must be early and effective to prevent an extended intestinal necrosis that requires making a great sacrifice of intestine. The two-stage surgery including suture perforation with stoma (ileum or colon) followed by a delayed recovery of digestive continuity was the attitude adopted in most of the cases [3]. In our patient we performed a one stage surgery because of the good condition of the patient, a clean abdominal cavity and the stoma refusal of the older people in our context.…”

“…The first description was made in 1827 by Sir Benjamin Brodie [1]. Since then several cases have been reported worldwide and recently in Senegal in 2011 [2], in India in 2013 [3], in Spain in 2014 [4]. We report our first case of transanal evisceration of small bowel in order to describe the circumstances of occurrence and our therapeutic approach.…”

Rectal prolapse with ileum and sigmoid colon eventration

“…Большинство авторов [17,26] сходятся во мнении, что операцию следует начинать с лапаротомии, однако M. Antony и M. Memon [6] в 2005 г. опубликовали успешный опыт применения лапароскопической техники в случае, подобном нашему (однако без некроза кишки). Считается, что некротизированная кишка должна быть резецирована из промежностного доступа [12,24,27].…”

“…По данным литературы, после репозиции тонкой кишки дефект стенки прямой кишки чаще ушивают трансанально, а затем при наличии ректального пролапса большинство авторов рекомендуют резекцию прямой кишки с наложением анастомоза (операцию Альтемаера) и превентивной стомой [8,17]. Другие авторы описывают операцию Тирша с превентивной сигмостомией как более щадящую у больных с высоким риском развития осложнений [26].…”