Incarcerated rectal prolapse—Rupture and ileal evisceration after failed reduction

Abstract

We report a case of incarcerated rectal prolapse that could not be reduced after using the previously described application of ordinary table sugar. Gentle pressure caused the prolapsed rectum to perforate, and the small bowel herniated through the tear. This is only the second case reported in the literature of an ileal herniation through a perforated rectum after an attempted reduction of an incarcerated prolapse. It is the only reported case occurring after sugar application and the 42nd case of ileal herniation through the rectum from all causes.

Strangulated Transanal Evisceration of Small Bowel Complicating Rectal Prolapse of the Child: An Observation of the University Hospital Center of Parakou, Benin

“…In addition, computed tomography may be useful for detecting presence of air outside the rectosigmoid junction. This suggests a parietal rupture and may help plan a surgical procedure [15].…”

“…A X-ray of the abdomen without preparation can detect peritoneal and retroperitoneal emphysema [15]. In addition, computed tomography may be useful for detecting presence of air outside the rectosigmoid junction.…”

Rupture of sigmoid colon with evisceration of bowel loops through the anus

“…Herniation of small bowel through the colon results in obstruction of the lumen of ruptured recto-sigmoid, blocking the passage of colonic contents into the peritoneal cavity and development of faecal peritonitis. [3][4][5] This rare condition can be prevented by elimination of the precipitating factor-rectal prolapse.…”

Unusual Causes of Large Bowel Perforation – A Report of Three Cases

“…Two factors predispose the patients to this unusual complication -sudden increase in intra-abdominal pressure and presence of rectal prolapse. Most believe that the primary mechanism of prolapse is a sliding hernia in which pouch of Douglas and the contained viscera form the hernia sac which invaginates the anterior wall of rectum resulting in weakening of the rectal wall [4,5] . Bowel is examined for viability after reduction in the peritoneal cavity.…”

“…Alternatively a Hartmann operation may be needed, with restoration of bowel continuity at a later stage [4] . Herniation of small bowel through the colon results in obstruction of the lumen of ruptured recto-sigmoid, blocking the passage of colonic contents into the peritoneal cavity and development of fecal peritonitis [3,4,5] .This rare condition can be prevented by elimination of the precipitating factor -rectal prolapse. Stercoral perforation has been defined as perforation of the large bowel due to pressure necrosis from fecal masses.…”