Transanal Small Bowel Evisceration in a 3-Year-Old Victim of Motor Vehicle Accident

Abstract

Although motor vehicle accidents (MVAs) in children are common, pediatric rectal perforations secondary to MVAs leading to transanal evisceration of the small bowel are very rare. Herniation of bowel through breach in the rectal wall seen eviscerating through the anus is a surgical emergency requiring laparotomy and necessary surgical procedure. We report case of a 3-year-old boy, victim of run-over MVA accident, presenting with bilateral fracture shaft femur, fracture of the left humerus, and transanal small bowel evisceration. About 30–40 cm long, gangrenous, small bowel loop was hanging outside the anal canal. Two consecutive surgeries were performed to manage this unusual and complex case with an excellent outcome. This report is presented for an extremely rare presentation of MVA injury in a child.

Rectal Prolapse and Spontaneous Perforation Causing Transanal Evisceration of the Small Bowel: A Case Report. Clinical History May Predict this Condition

“…Around 20 of the published cases belong to the pediatric population (age: 4 months-16 years-old), with different etiological factors from adults and trauma as the leading cause [1]. 9cases were caused by transanal suction from a swimming pool drain [2,3] blunt abdominal trauma [4], 3 related to penetrating injury and 1 case in an infant caused by intense coughing [5]. In adult patients, this condition is usually caused by trauma (including iatrogenic perforation), and spontaneous perforation which etiology remains uncertain [6].…”