[Sharon]

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Small bowel evisceration through the anus can occur spontaneously or post traumatically. Traumatic transanal small bowel evisceration results from iatrogenic injuries, suction injuries, and blunt abdominal trauma (BAT). This 48-year-old female presented with evisceration of small intestinal loops through the anus following BAT - a rare injury.



Most of the blunt abdominal injuries result from road traffic accidents, and majority of the patients have multisystem injuries. The incidence of major intestinal injuries among patients sustaining blunt abdominal trauma (BAT) ranges from 5-15% in various series.

Transanal small bowel evisceration (TSBE) following BAT results from associated rectal or rectosigmoid perforation and requires special mention due to its extraordinary presentation. Early recognition of bowel injuries can be difficult and a high grade of suspicion is mandatory.

A 48-year-old female presented to the emergency department with complaints of severe abdominal pain and protrusion of bowel loops through the anus. She gave a history of assault with a direct kick over the lower abdomen 8 hours before presentation. On presentation, she was conscious with a pulse rate of 98/minute and blood pressure of 100/60 mmHg. The abdomen was tender and loops of congested small intestine were seen protruding through the anus. There were no other associated injuries. The patient was resuscitated and transferred for urgent laparotomy.

During laparotomy, a longitudinal rent was seen at the antimesenteric border of rectosigmoid region with ileal loops entering the large bowel lumen. There was no hemoperitoneum or fecal contamination of peritoneal cavity. No other solid organ injury was detected. Small bowel loops were gently reduced in the abdominal cavity; warm moist packs applied and viability ascertained. Primary closure of sigmoid done in two layers and abdomen closed after thorough peritoneal lavage.



The patient was under intensive care for 48 hours and discharged on the seventh postoperative day. The patient is healthy on two months follow-up.

[Mollydoublybarrly]

Poor woman, very lucky that there was no perforation and that she survived through a successful surgery

[30564U]

It looks like she's grown a tail.

[Shakey]

Shitting sausage.

[Wench]

Jeeeeezustapdancingchrist!!!!!!!!! I hope she gets the perp's balls between 2 bricks!! Hopefully she knows where the douchenozzle sleeps

[Desensitisation]

Originally Posted by Mollydoublybarrly ↗

Poor woman, very lucky that there was no perforation and that she survived through a successful surgery

Actually, you are wrong; there was a perforation in the descending colon. That's how the small intestine ended up in the colon and out the anus. The small intestine rarely telescopes or intussuscepts more than a few inches when it does and wouldn't make it all the way out of the anus.

What happened here was a kick to the stomach caused a perforation along a part of the descending colon, and a loop of small intestines then fed into this perforation and out of the anus. In surgery the small intestines were pulled back through that perforation back into the abdomen, the perforated colon was closed, the abdomen lavaged to clean out any remnant of fecal contamination, and then she was closed up.

[vagabond]

Aye, caramba! Poor woman- I would totally freak, myself.

[LadyCPlum]

And this is how we make Andouille sausage in Louisiana

[corpsehands]

Goddamn thats unpleasant

[xthabeast]

She shit herself....LITERALLY