Transrectal small bowel evisceration (TSBE) is a rare entity that can occur after traumatic injuries. It has been described after impalement, sexual assault, blunt abdominal trauma, and swimming pool drain suction. The authors encountered such a case in a 4-year-old by following a crush abdominal injury. A laparotomy was performed. The eviscerated bowel was pulled inside the abdominal cavity, revealing the rectal perforation. A portion of devascularized ileum was resected, a primary bowel anastomosis was performed, and the longitudinal rectal laceration was repaired with a two-layered closure. There was no fecal soilage, and no protective colostomy was performed. The mortality and morbidity of TSBE are usually related with the severity and type of trauma. The mesenteric laceration and concomitant injuries can cause significant bleeding leading to a hemorrhagic shock and multiorgan failure.
To read this article in full you will need to make a payment
Purchase one-time access:Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
One-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:Subscribe to Journal of Pediatric Surgery
Already a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
- Acute transanal evisceration of the small bowel: report of a case and review of the literature.Dis Colon Rectum. 2003; 46: 1280-1283
- Prolapse of the rectum associated with spontaneous rupture of the distal colon and evisceration of the small intestine through the anus in an infant.J Pediatr Surg. 2008; 43: 2291-2292
- Rectosigmoidal rupture caused by effort during defecation and acute evisceration of several loops of the small intestine through the anus.Ann Surg. 1961; 154: 967-971
- Anorectal impalement in a pediatric patient with transanal evisceration of small bowel.Pediatr Surg Int. 2011; 27: 1021-1024
- Gut prolapse into the perineum in a case of sexual assault.Indian J Pediatr. 2009; 76: 653-654
- Small bowel evisceration through the rectum in childhood.J Pediatr Surg. 2008; 43: 562-563
- Rectosigmoid perforation and intestinal evisceration from transanal suction.J Pediatr Surg. 1983; 18: 10-13
- Transanal wading pool suction-drain injury resulting in complete evisceration of the small intestine: case report and review of the literature.J Pediatr Surg. 2010; 45: E1-E3
- Spontaneous rupture of the rectum with evisceration of the small intestine through the anus.Eur J Surg. 1995; 161: 925-927
- Rectal tear causing prolapsed ileum after closed abdominal injury.Injury. 1977; 9: 168-169
- Blunt traumatic evisceration of intestinal loops through the anus—a case report and a review of the literature.Ir Med J. 1984; 77: 396-397
- Evisceration of the small intestine due to rectum rupture.Ned Tijdschr Geneeskd. 1995; 139: 2653-2655
- Transanal small bowel evisceration from abdominal crush injury: case report and review of the literature.J Trauma. 2001; 50: 934-936
- Transanal evisceration of the small bowel from blunt abdominal trauma.Niger J Surg Res. 2006; 8: 182-184
- Transanal evisceration of bowel loops due to blunt trauma.J Indian Assoc Pediatr Surg. 2007; 12: 231-232
- Rectal perforation and evisceration of the small intestine: a rare injury in blunt trauma of the abdomen.J Trauma. 2009; 66: 286
- Transanal evisceration of the small intestine in a child secondary to blunt trauma to the abdomen: report of a case.Pan Afr Med J. 2011; 10: 50
- A rare presentation of crush injury: transanal small bowel evisceration. Case report and review of the literature.J Pediatr Surg. 2007; 42: E23-E25
Accepted: July 20, 2012
Received: June 20, 2012
© 2012 Elsevier Inc. Published by Elsevier Inc. All rights reserved.