A case of small bowel evisceration through the rectum and anus
Farrugia, Alexia Sarma, Diwakar Mobarak, Dham
Farrugia, Alexia
Sarma, Diwakar
Mobarak, Dham
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Sandwell and West Birmingham NHS Trust
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Publication date
2024-07-16
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Abstract
A 46-year-old man presented with a small bowel prolapsing through the anus after straining on the toilet, which was starting to become ischaemic. He admitted to inserting a plastic object in his rectum about half an hour before straining. The bowel was kept moist by placing an intravenous drip line with saline dripping onto a wet swab. In theatre, the bowel was found to be prolapsing through a hole in the upper rectum and out through the anus. It was reduced back into the abdominal cavity through the same perforation, which was 4 cm long, without needing to extend it. This was sutured with polydioxanone (PDS) 2-0 as there was no contamination with faeces or pus. Due to improvement in the appearance of a small bowel and an extremely bruised mesentery, a re-look was planned in 24 hours. At the re-look the small bowel appeared healthy, therefore no resection was performed. However, a loop colostomy was fashioned to protect the upper rectal perforation repair. This shows that resection is not always required in such cases.
Citation
Farrugia A, Sarma D, Mobarak D. A case of small bowel evisceration through the rectum and anus. Br J Hosp Med (Lond). 2024 Jul 30;85(7):1-3. doi: 10.12968/hmed.2024.0043
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