1
|
Gelas T, Combet S, Perinel J, Javouhey E, Mure PY. Transrectal small bowel evisceration after abdominal crush injury. J Pediatr Surg 2012; 47:e53-6. [PMID: 23164034 DOI: 10.1016/j.jpedsurg.2012.07.058] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2012] [Accepted: 07/20/2012] [Indexed: 11/17/2022]
Abstract
Transrectal small bowel evisceration (TSBE) is a rare entity that can occur after traumatic injuries. It has been described after impalement, sexual assault, blunt abdominal trauma, and swimming pool drain suction. The authors encountered such a case in a 4-year-old by following a crush abdominal injury. A laparotomy was performed. The eviscerated bowel was pulled inside the abdominal cavity, revealing the rectal perforation. A portion of devascularized ileum was resected, a primary bowel anastomosis was performed, and the longitudinal rectal laceration was repaired with a two-layered closure. There was no fecal soilage, and no protective colostomy was performed. The mortality and morbidity of TSBE are usually related with the severity and type of trauma. The mesenteric laceration and concomitant injuries can cause significant bleeding leading to a hemorrhagic shock and multiorgan failure.
Collapse
Affiliation(s)
- Thomas Gelas
- Department of Pediatric Surgery, Hospital Femme Mère Enfant, Hospices Civils de Lyon and Claude Bernard University, France.
| | | | | | | | | |
Collapse
|
2
|
Corduk N, Koltuksuz U, Karabul M, Savran B, Bagci S, Sarioglu-Buke A. A rare presentation of crush injury: transanal small bowel evisceration. Case report and review of the literature. Pediatr Surg Int 2011; 27:1021-4. [PMID: 21190115 DOI: 10.1007/s00383-010-2817-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/15/2010] [Indexed: 10/18/2022]
Abstract
Evisceration of the small intestine through the anus is an extremely rare event in children. We report a 2-year-old boy who sustained transanal small bowel evisceration associated with bilateral diaphragmatic rupture, left diaphragmatic herniation, and spinal cord injury without radiographic abnormality which happened after crushing by motor vehicle. We reviewed children with transanal small bowel evisceration and discussed etiological differences between children and adult. We also discussed the basic principles of management and follow up in these patients.
Collapse
Affiliation(s)
- Nergul Corduk
- Pamukkale University Medical Faculty, Denizli, Turkey.
| | | | | | | | | | | |
Collapse
|
3
|
Price NR, Soundappan SV, Sparnon AL, Cass DT. Swimming pool filter-induced transrectal evisceration in children: Australian experience. Med J Aust 2010; 192:534-6. [PMID: 20438433 DOI: 10.5694/j.1326-5377.2010.tb03621.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2009] [Accepted: 02/10/2010] [Indexed: 11/17/2022]
Affiliation(s)
- Neil R Price
- Children's Hospital at Westmead, Sydney, NSW, Australia.
| | | | | | | |
Collapse
|
4
|
Juern J, Schmeling D, Feltis B. Transanal wading pool suction-drain injury resulting in complete evisceration of the small intestine: case report and review of the literature. J Pediatr Surg 2010; 45:E1-3. [PMID: 20385263 DOI: 10.1016/j.jpedsurg.2010.01.020] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2009] [Revised: 01/15/2010] [Accepted: 01/16/2010] [Indexed: 10/19/2022]
Abstract
Suction evisceration from a pool drain is a rare injury. This child presented with what appeared to be isolated perineal trauma. Ultimately, the patient was found to have complete transanal small bowel evisceration. Reported herein are the specifics of this case, along with a review of the relevant literature relating to this case.
Collapse
Affiliation(s)
- Jeremy Juern
- Department of Surgery, Hennepin County Medical Center, Minneapolis, MN 55415, USA
| | | | | |
Collapse
|
5
|
A 6-year-old boy presenting with traumatic evisceration following a bicycle handle bar injury: a case report. CASES JOURNAL 2009; 2:6315. [PMID: 19829784 PMCID: PMC2740083 DOI: 10.4076/1757-1626-2-6315] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/03/2009] [Accepted: 07/27/2009] [Indexed: 11/08/2022]
Abstract
We report the case of a 6-year-old boy presenting with small bowel evisceration following a fall onto a bicycle handle-bar. His case is presented, a review of the literature performed and interesting photos pre and post-op are presented.
Collapse
|
6
|
Rectal perforation and evisceration of the small intestine: a rare injury in blunt trauma of the abdomen. ACTA ACUST UNITED AC 2009; 66:286. [PMID: 18288019 DOI: 10.1097/01.ta.0000241170.09288.f9] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
7
|
Sengar M, Neogi S, Mohta A. Prolapse of the rectum associated with spontaneous rupture of the distal colon and evisceration of the small intestine through the anus in an infant. J Pediatr Surg 2008; 43:2291-2. [PMID: 19040957 DOI: 10.1016/j.jpedsurg.2008.09.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2008] [Revised: 08/25/2008] [Accepted: 09/01/2008] [Indexed: 10/21/2022]
Abstract
Prolapse of rectum of varying degrees is a well-known entity in children. Spontaneous rupture of the rectum along with massive ileal evisceration because of increased intraabdominal pressure is a rare complication of rectal prolapse in the adults. Rectal prolapse in children is usually a benign condition. Known complications of the rectal prolapse in children include recurrent mucosal ulceration, bleeding, and proctitis. Spontaneous rupture of the rectum with or without ileal evisceration has not been previously reported in infants.
Collapse
Affiliation(s)
- Mamta Sengar
- Department of Pediatric Surgery, Chacha Nehru Bal Chikitsalaya, affiliated to Maulana Azad Medical College, Geeta colony, Delhi 110031, India.
| | | | | |
Collapse
|
8
|
Transanal Small Bowel Evisceration: An Unusual Presentation of Rectal Impalement. Eur J Trauma Emerg Surg 2008; 34:606. [PMID: 26816288 DOI: 10.1007/s00068-008-7097-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2007] [Accepted: 06/05/2008] [Indexed: 10/21/2022]
Abstract
Traumatic transanal small bowel evisceration is a rare condition usually associated with suction injuries or blunt abdominal trauma. We report the first case of intestinal evisceration through the anus caused by penetrating trauma (rectal impalement). Additionally, we performed a literature review of all English language articles since 1970 concerned with traumatic transanal small bowel evisceration. Mechanisms of injury and the surgical management are discussed.
Collapse
|
9
|
Ravikumar R, Robb A, Jawaheer G. Small bowel evisceration through the rectum in childhood. J Pediatr Surg 2008; 43:562-3. [PMID: 18358303 DOI: 10.1016/j.jpedsurg.2007.11.008] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2007] [Revised: 10/31/2007] [Accepted: 11/01/2007] [Indexed: 11/16/2022]
Abstract
Small bowel evisceration through the rectum is extremely rare in childhood and has previously been reported in association with swimming pool suction injuries. We report a case of ileal evisceration resulting from a self-inflicted injury in a teenaged boy. Such a mechanism of injury leading to evisceration of the small bowel is previously unreported in children or adults.
Collapse
Affiliation(s)
- Reena Ravikumar
- Department of Paediatric Surgery, Birmingham Children's Hospital, B4 6NH Birmingham, UK
| | | | | |
Collapse
|
10
|
Valletta E, Zampieri N, Fornaro M, Biban P, Marzini S, Camoglio FS. Transanal intestinal evisceration from swimming pool skimmer suction: a spur to prevention. Acta Paediatr 2007; 96:1376-7. [PMID: 17718800 DOI: 10.1111/j.1651-2227.2007.00418.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
11
|
Koffeman GI, van Gemert WG, George EK, Veenendaal RA. Classification, epidemiology and aetiology. Best Pract Res Clin Gastroenterol 2003; 17:879-93. [PMID: 14642855 DOI: 10.1016/s1521-6918(03)00099-4] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Intestinal failure and its most important cause, short-bowel syndrome (SBS), are rare clinical entities leading to a vast complex of symptoms and complications with significant morbidity and mortality. Both conditions occur as the result of a massive reduction in enteral nutrient absorptive capacity. Disease manifestation is based on aetiological and anatomical characteristics such as remaining intestinal length and the presence of a functionally intact colon. Congenital and perinatal conditions, for example, intestinal atresia, necrotizing enterocolitis (NEC) and intestinal volvulus are the most important causes in children. The aetiology in adults is based on diseases inducing loss of intestinal function or loss of intestinal surface area after extensive surgical resections. The most frequent causes are mesenteric infarction, radiation enteritis and Crohn's disease. Knowledge of the epidemiology of intestinal failure and SBS is limited, being mainly based on the extrapolated figures of home parenteral nutrition centres and single-centre studies. At present, the incidence of SBS is estimated to be 2-5 per million.
Collapse
Affiliation(s)
- Geert I Koffeman
- Paediatric Surgical Centre Amsterdam, Academic Medical Center, Amsterdam, P.O. Box 22700, 1105 AZ, Amsterdam, The Netherlands.
| | | | | | | |
Collapse
|
12
|
Gomez-Juarez M, Cascales P, Garcia-Olmo D, Gomez-Juarez F, Usero S, Capilla P, Garcia-Blazquez E. Complete evisceration of the small intestine through a perianal wound as a result of suction at a wading pool. THE JOURNAL OF TRAUMA 2001; 51:398-9. [PMID: 11493808 DOI: 10.1097/00005373-200108000-00033] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- M Gomez-Juarez
- Department of General Surgery, Albacete General Hospital, Albacete, Spain
| | | | | | | | | | | | | |
Collapse
|
13
|
Rechner P, Cogbill TH. Transanal small bowel evisceration from abdominal crush injury: case report and review of the literature. ACTA ACUST UNITED AC 2001; 50:934-6. [PMID: 11371856 DOI: 10.1097/00005373-200105000-00028] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- P Rechner
- Department of Surgery, Gundersen Lutheran, 1836 South Avenue, La Crosse, WI 54601, USA
| | | |
Collapse
|
14
|
Jiménez Moya A, Gracia Remiro R, Penela Vélez de Guevara T, Santana Rodríguez C, Sierra Pérez E, Herrera Martín M. Lesiones por succión en piscinas públicas. An Pediatr (Barc) 2001. [DOI: 10.1016/s1695-4033(01)77750-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
|
15
|
Abstract
Short bowel syndrome has significant morbidity and is potentially lethal especially when intestinal loss is extensive. The pathophysiology of short bowel syndrome, its aetiology, prognosis and our understanding of the mechanisms of adaptation are reviewed. Management by a multi-disciplinary nutritional care team is advocated and should be directed to the maintenance of growth and development, the promotion of intestinal adaptation, the prevention of complications and the establishment of enteral nutrition. The choice of enteral feed, the role of drugs and the use of pro-adaptive nutrients and agents are discussed. Complications including cholestasis and catheter related sepsis are outlined with strategies to reduce them. Finally the roles of secondary surgical interventions including transplantation are discussed.
Collapse
Affiliation(s)
- I W Booth
- Institute of Child Health, University of Birmingham, UK
| | | |
Collapse
|
16
|
Abstract
The causes of rectal trauma are many and varied. The most frequent cause is iatrogenic. Treatment depends on the severity of the injury; and the accurate assessment of the injury is essential. Rectal foreign bodies are either ingested or inserted through the anus. Foreign bodies usually can be extracted by nonsurgical methods but appropriate technique is required to avoid rectal or sphincteric laceration.
Collapse
Affiliation(s)
- R D Fry
- Department of Surgery, Jefferson Medical College of Thomas Jefferson University, Philadelphia, Pennsylvania
| |
Collapse
|
17
|
Abstract
This is the 31st report of spontaneous transanal evisceration of small bowel. This case is unique because a rectal prolapse had been repaired previously and at the time of evisceration, there was no evidence of recurrence. Inherent or acquired weakness of the anterior rectal wall combined with a sudden increase in intra-abdominal pressure appears to precipitate this rare phenomenon. Attention to basic surgical tenets applies in the management of this condition.
Collapse
|