Abstract

LEE, HJ; HENDRICKS, D; RANGAKA, T  and  ABD ELRAHMAN, A. Trans-anal small bowel evisceration in a patient with a perforated rectal prolapse. S. Afr. j. surg. [online]. 2023, vol.61, n.3, pp.42-43. ISSN 2078-5151.  https://doi.org/10.36303/sajs.3998.

An 85-year-old lady with a history of chronic constipation presented with gangrenous small bowel protruding from the anus through a hole in a prolapsed rectum. At surgery, a resection of 125 cm of gangrenous small bowel was performed in the perineum prior to laparotomy, where rectal repair was followed by the creation of a sigmoid loop colostomy and double-barrel ileostomy. This avoided an intrabdominal anastomosis which was felt likely to complicate due to the lady's intraoperative haemodynamic instability requiring inotropic support. This tailored management of a trans-anal small bowel evisceration through a rectal prolapse resulted in recovery and a patient who was content with her stomas and preferred to live with them rather than have continuity restored.

Keywords : small bowel evisceration; rectal prolapse.

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