Small Bowel Prolapse From Anus; Atypical Presentation of Rectal Perforation

Akbulut, Sezer; Bozkurt, Mehmet Abdussamet; Kabuli, Hamit Ahmet; Güneş, Mehmet Emin

doi:10.5505/tjtes.2018.40149

Cited by 3 publications

(5 citation statements)

References 3 publications

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“…The rectal prolapse may lead to chronic ischaemic insult of the rectal wall, resulting in thinning and subsequent perforation 2. In previous reports, mostly the anterior wall of the rectum was affected, like in our case 1–3…”

Section: Discussionsupporting

confidence: 54%

“…Risk factors are untreated chronic rectal prolapses or gynaecological comorbidities, like endometriosis 1 7. The rectal prolapse may lead to chronic ischaemic insult of the rectal wall, resulting in thinning and subsequent perforation 2. In previous reports, mostly the anterior wall of the rectum was affected, like in our case 1–3…”

Section: Discussionmentioning

confidence: 61%

“…Spontaneous rectal perforations with transanal small bowel herniation are extremely rare emergencies with a dramatic clinical presentation. Less than 100 cases have been published since the first description in the literature by Brodie in 1927 2–5. In most of these cases, small intestine is involved.…”

Section: Discussionmentioning

confidence: 99%

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Rare case of an 83-year-old woman with transrectal small bowel evisceration caused by spontaneous rectal perforation

2022

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Spontaneous rectal perforation with transanal small intestinal evisceration is a rare condition. We report the case of an 83-year-old woman with a rectal perforation and transanal prolapse of small intestine through the rectal opening who was treated with transanal reposition under general anaesthesia and open Hartmann’s procedure. As part of the Hartmann’s procedure, segmental resection of the perforated colon was performed. This case illustrates that spontaneous rectal perforation is a severe surgical emergency, which needs immediate reposition and resection of the perforated rectum.

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Section: Discussionsupporting

confidence: 54%

Section: Discussionmentioning

confidence: 61%

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Rare case of an 83-year-old woman with transrectal small bowel evisceration caused by spontaneous rectal perforation

2022

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“…Based on the macroscopic appearance of the rectal tear and probable associated pathology, surgical procedures such as primary repair with or without a proximal defunctioning stoma or Hartman's procedure with a proximal end stoma have been attempted. [22][23][24] In the reported patient, a decision was made to proceed with proximal defunctioning ileostomy due to the concern of an underlying pathology.…”

Section: Discussionmentioning

confidence: 99%

Spontaneous evisceration of small bowel through the rectum in the background of rectal prolapse

Basnayake

Jayarajah

Wijerathne³

2021

SAGE Open Medical Case Reports

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Small bowel evisceration secondary to rectal prolapse is an uncommon complication with significant morbidity and mortality if left untreated. We report a rare case of the spontaneous evisceration of the small bowel through the rectum in the background of rectal prolapse. A 73-year-old female presented to the emergency treatment unit with sudden worsening of her rectal procidentia (rectal prolapse) and pain for 3 h precipitated by straining at defecation. She had a history of complete rectal prolapse for 4 years and three uncomplicated vaginal deliveries. On examination, she was found to have evisceration of the small bowel through the anus without any evidence of strangulation. Emergency laparotomy was performed and small bowel was reduced into the abdomen with ease. She was found to have a linear tear on the anterior wall of the rectum. Primary repair of the rectal defect was carried out and a proximal defunctioning ileostomy was created. Histology was unremarkable and the recovery was uneventful. Old age, history of previous vaginal deliveries, and long-standing rectal prolapse were probable risk factors in this patient. Delay in treating this condition may result in significant morbidity and even mortality. Therefore, timely intervention is necessary.

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“…After assessing patient's hemodynamic status, a contrast enhanced abdomino-pelvic CT scan should be performed to investigate potential conditions associated with complicated RP [213][214][215][216], such as acute bowel obstruction, signs of perforation and peritonitis, prolapse of other pelvic organs (uterus, vagina and/or bladder, sigmoid colon, small bowel) [217], and to rule out the presence of colorectal malignancy. A sudden RP could be the first clinical manifestation of a colon cancer, as demonstrated by several case reports [218][219][220][221]; therefore, multiple authors suggest that patients with rectal prolapse should have endoscopic examination of the colon and rectum.…”

Section: B -In Patients With a Suspected Complicated Rectal Prolapse Which Are The Appropriate Imaging Investigations?mentioning

confidence: 99%

Anorectal emergencies: WSES-AAST guidelines

et al. 2021

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Anorectal emergencies comprise a wide variety of diseases that share common symptoms, i.e., anorectal pain or bleeding and might require immediate management. While most of the underlying conditions do not need inpatient management, some of them could be life-threatening and need prompt recognition and treatment. It is well known that an incorrect diagnosis is frequent for anorectal diseases and that a delayed diagnosis is related to an impaired outcome. This paper aims to improve the knowledge and the awareness on this specific topic and to provide a useful tool for every physician dealing with anorectal emergencies.The present guidelines have been developed according to the GRADE methodology. To create these guidelines, a panel of experts was designed and charged by the boards of the World Society of Emergency Surgery (WSES) and American Association for the Surgery of Trauma (AAST) to perform a systematic review of the available literature and to provide evidence-based statements with immediate practical application. All the statements were presented and discussed during the WSES-AAST-WJES Consensus Conference on Anorectal Emergencies, and for each statement, a consensus among the WSES-AAST panel of experts was reached. We structured our work into seven main topics to cover the entire management of patients with anorectal emergencies and to provide an up-to-date, easy-to-use tool that can help physicians and surgeons during the decision-making process.

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Small Bowel Prolapse From Anus; Atypical Presentation of Rectal Perforation

Cited by 3 publications

References 3 publications

Rare case of an 83-year-old woman with transrectal small bowel evisceration caused by spontaneous rectal perforation

Rare case of an 83-year-old woman with transrectal small bowel evisceration caused by spontaneous rectal perforation

Spontaneous evisceration of small bowel through the rectum in the background of rectal prolapse

Anorectal emergencies: WSES-AAST guidelines

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