Small bowel transanal evisceration mimicking a rectal prolapse.

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COD: 2783_14_11_2017_EP Categorie: , ,

Giuseppe Pisano, Enrico Erdas, Fabio Medas, Umberto Pisano, Pietro Giorgio Calò

Ann Ital Chir, Digital Edition 2018, 7
Epub, November 14

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Transanal intestinal evisceration is a very uncommon and dramatic occurrence, linked most frequently to rectal prolapse
rupture or, very rarely, to traumatic pathology. The Authors describe a case of a 74-year-old female patient who required
urgent hospital admission because of a seemingly strangulated rectal prolapse. During surgical preparation the protruding
mass was recognized as small bowel loops herniating from the anus. Evisceration was due to spontaneous rectal wall
rupture, most likely caused by increased abdominal pressure and consequent breach through the weakened rectum. Surgical
treatment consisted in small bowel resection combined with an Hartmann’s procedure.
Spontaneous rectal rupture without a pre-existing rectal prolapse is a rather infrequent and challenging condition; its
mechanism is still incompletely explained. The management is surgical and may range from primary repair up to extensive
intestinal resection to include a defunctioning colostomy.