Transanal evisceration of the small bowel - report of a case.

Transanal intestinal evisceration is an extremely rare pathologic condition. Its presentation is quite dramatic as it involves the small bowel eviscerating through a rectal wall defect intraluminally and exiting transanally. We present the case of a 91-year-old female with history of rectal bleeding due to local ischemia of the anterior rectal wall, who presented to us with intestinal loops extruding through the anus. The patient underwent prompt surgical intervention with segmental small bowel resection, resection of the rectum, and construction of an end colostomy, with a smooth postoperative recovery. Our report highlights local ischemia of the anterior rectal wall as an etiopathogenic factor and stresses its role as an alarm sign for subsequent rectal perforation with evisceration of the small intestine.