Transrectal evisceration caused by colorectal injury is an unusual entity. This pathology is more frequent in elderly patients and it is usually produced spontaneously. Rectal prolapse is the principal predisposing factor. An 81-year-old woman was taken to the hospital presenting exit of intestinal loops through the anus. After first reanimation measures, an urgent surgery was indicated. We observed the absence of almost every small intestine loop in the abdominal cavity; these had been moved to the pelvis. After doing the reduction, a 3 to 4 cm linear craniocaudal perforation in upper rectum was objectified, and Hartmann's procedure was performed. We investigated and knew that she frequently manipulate herself to extract her faeces. The fast preoperative management avoided a fatal conclusion or an extensive intestinal resection. Reasons that make us consider rectal self-injury as the etiologic factor are explained.

Citations

Citations to this article as recorded by  

• Transanal evisceration of small bowel in two patients with chronic rectal prolapse: case presentation and literature review
  S Hajiev, A Ezzat, V Sivarajah, G Reese, N El-Masry
  The Annals of The Royal College of Surgeons of England.2021; 103(1): e29.     CrossRef
• Evisceración de asas intestinales a través de periné posterior por traumatismo en paciente anciano
  Ana Alicia Tejera Hernández, David Fernández San Millan, Carlos David Trujillo Flores, Juan Ramón Hernández Hernández
  Revista Española de Geriatría y Gerontología.2016; 51(1): 58.     CrossRef
• Transanal Evisceration of Small Bowel about One Case at the University Hospital Yalgado Ouédraogo of Ouagadougou
  Adama Sanou, Moussa Bazongo, Edgar Ouangré, Maurice Zida, Gilbert Patindé Bonkoungou, Rodrique Namékinsba Doamba, Sylvain Wendmi Karfo, Elie Yamba Sawadogo, Nayi Zongo, Si Simon Traoré
  Surgical Science.2016; 07(07): 291.     CrossRef

Although the treatment strategy for colorectal trauma has advanced during the last part of the twentieth century and the result has improved, compared to other injuries, problems, such as high septic complication rates and mortality rates, still exist, so standard management for colorectal trauma is still a controversial issue. For that reason, we designed this article to address current recommendations for management of colorectal injuries based on a review of literature. According to the reviewed data, although sufficient evidence exists for primary repair being the treatment of choice in most cases of nondestructive colon injuries, many surgeons are still concerned about anastomotic leakage or failure, and prefer to perform a diverting colostomy. Recently, some reports have shown that primary repair or resection and anastomosis, is better than a diverting colostomy even in cases of destructive colon injuries, but it has not fully established as the standard treatment. The same guideline as that for colonic injury is applied in cases of intraperitoneal rectal injuries, and, diversion, primary repair, and presacral drainage are regarded as the standards for the management of extraperitoneal rectal injuries. However, some reports state that primary repair without a diverting colostomy has benefit in the treatment of extraperitoneal rectal injury, and presacral drainage is still controversial. In conclusion, ideally an individual management strategy would be developed for each patient suffering from colorectal injury. To do this, an evidence-based treatment plan should be carefully developed.

Citations

Citations to this article as recorded by  

• The Role of Diagnostic Laparoscopy in the Evaluation of Abdominal Trauma Patients: A Trauma Quality Improvement Program Study
  Han‐Hsi Chiu, Yu‐San Tee, Chih‐Po Hsu, Ting‐An Hsu, Chi‐Tung Cheng, Chien‐Hung Liao, Chi‐Hsun Hsieh, Chih‐Yuan Fu
  World Journal of Surgery.2023; 47(10): 2357.     CrossRef
• Laparoscopic treatment for colonic injuries following penetrating trauma: A feasible option in a surgical department of Sub-Saharan Africa
  Abdourahmane Ndong, Adja Coumba Diallo, Mohamed Lamine Diao, Jacques Noel Tendeng, Ndiamé Sarr, Ismael Bayo Racine, Jacques Diounda Diatta, Saer Diop, Modou Gaye, Moustapha Diedhiou, Philippe Manyacka Ma Nyemb, Ibrahima Konaté
  Trauma Case Reports.2022; 42: 100708.     CrossRef
• UEG Week 2020 Oral Presentations
  
  United European Gastroenterology Journal.2020; 8(S8): 8.     CrossRef
• Effective Laparoscopy to Diagnose Early Widespread Colon Injury by Compressed Air—A Case Report—
  Masayuki KANZAKI, Hiroshi KOTEGAWA, Tatsuhiko KUME, Atsushi HORIUCHI, Shun AKEHI
  Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association).2019; 80(4): 755.     CrossRef
• Nonoperative Management of Multiple Penetrating Cardiac and Colon Wounds from a Shotgun: A Case Report and Literature Review
  Paula M. Jaramillo, Jaime A. Montoya, David A. Mejia, Salin Pereira Warr
  Case Reports in Surgery.2018; 2018: 1.     CrossRef
• Similar mechanisms of traumatic rectal injuries in patients who had anal sex with animals to those who were butt-fisted by human sexual partner
  Damian Jacob Sendler
  Journal of Forensic and Legal Medicine.2017; 51: 69.     CrossRef
• Is Ostomy Still Mandatory in Rectal Injuries?
  Burak Veli Ulger, Ahmet Turkoglu, Abdullah Oguz, Omer Uslukaya, Ibrahim Aliosmanoglu, Mesut Gul
  International Surgery.2013; 98(4): 300.     CrossRef