Impalement Injury with Transanal Prolapse of Bowel Content Due to Intraperitoneal Rectal Tear

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.Open in a separate windowFig. 1Patient presented with prolapse of bowel contents per rectum due to injuryOpen in a separate windowFig. 2Intraoperative picture showing the perforation involving the rectum