Abstract
There have been many reports of idiopathic rectal rupture both in Japan and overseas, but we report herein on a case of rectal rupture associated with small bowel prolapse through the anus, including a discussion based on the literature. The patient was a 69-year-old woman who noticed intestinal prolapse through her anus when she had bowel movements and she was examined by a local physician who referred her to the emergency and critical care center of our hospital for treatment. On arrival at the center, the small bowel was prolapsed through the anus for a distance of about 50cm. The prolapsed intestine appeared slightly dark-red. An emergency laparotomy was performed, and the small bowel was found to have entered the rectum through a longitudinal perforation of the anterior wall of the sigmoid colon and prolapsed outside the body through the anus. Rectal rupture associated with small bowel prolapse is a very rare disease, with only 24 cases ever having been reported from our search of central medical abstracts. In many cases, including this case, there is a disease, such as repeated rectal prolapse, in which traction force is chronically exerted on the sigmoid colon or rectum, and that appears to have caused weakening of the intestinal wall and to have become a factor in the rupture.
