title: Transanal evisceration caused by rectal laceration.
abstract: Transrectal evisceration caused by colorectal injury is an unusual entity. This pathology is more frequent in elderly patients and it is usually produced spontaneously. Rectal prolapse is the principal predisposing factor. An 81-year-old woman was taken to the hospital presenting exit of intestinal loops through the anus. After first reanimation measures, an urgent surgery was indicated. We observed the absence of almost every small intestine loop in the abdominal cavity; these had been moved to the pelvis. After doing the reduction, a 3 to 4 cm linear craniocaudal perforation in upper rectum was objectified, and Hartmann's procedure was performed. We investigated and knew that she frequently manipulate herself to extract her faeces. The fast preoperative management avoided a fatal conclusion or an extensive intestinal resection. Reasons that make us consider rectal self-injury as the etiologic factor are explained.
authors.affiliation: Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitario Doctor Peset, Valencia, Spain.
authors.forename: Aleix
authors.initials: A
authors.lastname: Martínez Pérez
authors.affiliation: Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitario Doctor Peset, Valencia, Spain.
authors.forename: María Teresa
authors.initials: MT
authors.lastname: Torres Sánchez
authors.affiliation: Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitario Doctor Peset, Valencia, Spain.
authors.forename: Jose Manuel
authors.initials: JM
authors.lastname: Richart Aznar
authors.affiliation: Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitario Doctor Peset, Valencia, Spain.
authors.forename: Eva María
authors.initials: EM
authors.lastname: Martí Martínez
authors.affiliation: Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitario Doctor Peset, Valencia, Spain.
authors.forename: Manuel
authors.initials: M
authors.lastname: Martínez-Abad
keywords: Abdominal injuries; Intestinal perforation; Rectum