A Rare, Severe Complication of Delayed Surgical Treatment for Rectal Prolapse

Abstract

Transanal small bowel evisceration is a very rare presentation. However, it is associated with significant morbidity and mortality. Our case report describes an 84-year-old female with known rectal prolapse, who presented to the emergency room in sepsis with transanal small bowel evisceration after cancelation of her elective surgical repair. Due to her acutely ill presentation, she required a damage control operation, additional surgery, intensive care management, prolonged hospital stay, and a small bowel resection in addition to a colostomy. This shows the importance of timely, definitive surgical treatment for rectal prolapse, especially in healthy individuals who can tolerate surgical intervention.Surgery office after presenting to the emergency room with rectal prolapse, which was successfully reduced. The patient reported some mild constipation requiring stool softeners and had never had a colonoscopy. On the exam, she had a reduction in anal tone, and rectal prolapse was noted with straining. After discussion with the patient and her family, the decision was made to proceed with an open rectopexy and colonoscopy. About one month after her office visit, her family canceled her scheduled surgery, reporting that the patient's symptoms had resolved.Two months later, the patient presented to the hospital with small bowel herniation through her anus with compromised blood supply (Figure 1), which the