A case of small bowel evisceration through the rectum and anus
Farrugia, Alexia Sarma, Diwakar Mobarak, Dham
Farrugia, Alexia
Sarma, Diwakar
Mobarak, Dham
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.
MIDER Authors
Affiliations
Sandwell and West Birmingham NHS Trust
Citations
Altmetric:
Date
2024-07-16
Type
Article
Subject
Collections
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