A Case of Rectal Perforation with Transanal Small Bowel Prolapse

Abstract

The case of a 93-year-old woman with a history of rectal prolapse is presented. Her family discovered that her intestine had prolapsed from the anus and called for emergency medical assistance. When she came to our hospital, small bowel prolapse was observed from the anus. Abdominal computed tomography was performed, and small bowel prolapse from a perforation of the upper rectum was suspected. In emergency surgery, the prolapsed small bowel was returned into the abdominal cavity, and Hartmann's operation was performed. The patient had a good postoperative course and was discharged from the hospital on the 32nd day. Rectal perforation with transanal prolapse of the small bowel is a very rare condition, but its prognosis is better than that of colorectal perforation without prolapse of the small bowel. The reasons for this are thought to be that the small bowel fits into the perforation to minimize leakage of intestinal contents into the abdominal cavity, and that emergency surgery is performed at an early stage because of the appearance that can be easily diagnosed. In this report, a case of rectal perforation with transanal small bowel prolapse that was successfully treated with emergency surgery is presented.