A 48-eight-year-old female patient came with prolapse of small intestines per rectum (Fig. 1) due to impalement injury with iron rod at a construction site. As the patient was hemodynamically unstable, she was taken for emergency laparotomy. A large rent in the intraperitoneal rectum was found (Fig. 2), with prolapse of intestines. Luckily for the patient, there was no other intra-abdominal organ injury. As there was no fecal contamination at all, a decision against proximal colostomy was made. The rent was closed in two layers after re-placing the small bowel contents with thorough lavage. Patient made a swift recovery thereafter.
J M V Amarjothi, Rajkumar Williams, S A Inpharasun. Impalement injury with transanal prolapse of bowel content due to intraperitoneal rectal tear. The Indian journal of surgery. 2015 Feb;77(1):72
PMID: 25829719
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