Prolapse of the intestine through a spontaneous perforation in the anterior rectum

A 94-year-old woman with a history of rectopexy (2012) and vaginal hysterectomy came to the Emergency Department due to abdominal pain associated with spontaneous externalization of intestinal loops through the anus (Fig. 1). Thoracoabdominal computed tomography revealed severe prolapse and herniation of pelvic organs (Fig. 2).

Fig. 1

Fig. 2.

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Median laparotomy was performed, which revealed: a 6-cm perforation in the anterior rectum, 1 cm from the anal margin, associated with prolapse of the intestinal tract, without loss of viability. We performed reduction, closure of the defect, omentoplasty, and end colostomy. The patient’s progress was favorable, and she was discharged on the 11th postoperative day.