Transanal evisceration of the small bowel from blunt abdominal trauma

Evisceration of the small intestine through the anus has been reported to occur spontaneously and in association with trauma. Small bowel evisceration through a rectal injury caused by blunt abdominal trauma has been documented in association with a variety of injury mechanisms. We report a case of a 19 year old boy who sustained blunt injury to the thigh and pelvic region with a traumatic evisceration of the small bowel through the anus. There were no apparent abdominal injuries on examination. Unlike most cases reported in the medical literature, there was extensive peritoneal soiling with fecal matter as a result of multiple perforations of the small bowel. The disparity between the physical findings at initial examination and the extensive intraperitoneal injuries seen at laparatomy calls for a high index of suspicion in such cases.