Evisceration of small bowel through spontaneous perforation of rectum: Case report and review of literature

Introduction Small bowel evisceration through spontaneous perforation of the rectum is an extremely rare condition in which the small bowel herniates mostly through a defect in the anterior rectal wall. Case presentation We present the case of a 25-year-old otherwise healthy lady who denied any history of rectal prolapse or trauma. Discussion Small bowel evisceration through rectum is a rare surgical emergency with a mortality rate as high as 42.3%. Apart from trauma, chronic constipation, rectal prolapse, presence of a deep Douglas pouch and a sliding hernia formed by the cul-de-sac have also been described as etiological factors. Conclusion It is extremely difficult to find out the actual cause of “spontaneous” small bowel evisceration, especially in young adults.

Highlights • trans-Anal small bowel evisceration is an extremely rare condition with a high mortality rate. • If left untreated, this condition has 100% mortality. • It requires urgent surgical intervention. • Finding out its actual cause is very difficult. • rectal prolapse was commonly suggested as its main predisposing factor.