Jeong J, Park J S, Byun C G, Yoon D S, Sohn S K, Lee Y H, Chi H S
Department of Surgery, Yonsei University College of Medicine, Seoul, Korea.
Yonsei Med J. 2000 Apr;41(2):289-92. doi: 10.3349/ymj.2000.41.2.289.
Spontaneous rupture of the rectosigmoid colon and herniation of the small intestine through the rupture site and eventual evisceration through the anus is a very rare event. In the literature, only 42 cases have been reported. The majority of them occurred in patients with rectal prolapse and one case was reported in association with a third-degree uterine prolapse. We experienced an 81-year-old female patient with rectal prolapse and second-degree uterine prolapse complicated by spontaneous perforation of the rectosigmoid colon and anal evisceration of the small intestine. Segmental resection of the nonviable small intestine, primary repair of the ruptured rectosigmoid colon, and sigmoid loop colostomy were performed, and the patient recovered well. In our patient, both rectal and uterine prolapses cooperatively damaged the anterior wall of the rectosigmoid colon and resulted in perforation. So, rectal and uterine prolapses should be treated before the complication develops. In this patient, uterine prolapse should be treated because of the recurrence of this rare episode.
直肠乙状结肠自发性破裂，小肠经破裂部位疝出并最终经肛门脱出体外是一种非常罕见的情况。文献中仅报道了42例。其中大多数发生在直肠脱垂患者中，有1例报道与三度子宫脱垂相关。我们遇到一名81岁女性患者，患有直肠脱垂和二度子宫脱垂，并发直肠乙状结肠自发性穿孔和小肠经肛门脱出。对坏死的小肠进行了节段性切除，对破裂的直肠乙状结肠进行了一期修复，并做了乙状结肠袢式造口术，患者恢复良好。在我们的患者中，直肠和子宫脱垂共同损伤了直肠乙状结肠前壁并导致穿孔。因此，在并发症发生前应治疗直肠和子宫脱垂。在该患者中，由于这种罕见情况的复发，应治疗子宫脱垂。
