Spontaneous perforation of rectum with evisceration of small bowel simulating intussusception

CONTEXT: Spontaneous perforation of rectum is a rare event; however evisceration of the small bowel through the perforated site without predisposing factors is extremely rare, complex and worth reporting. CASE REPORT: A 14 years old presented to us apparently as a case of intussception. The operative findings revealed it to be a case of spontaneous perforation of rectum with evisceration of the small bowel through the perforation. CONCLUSION: Sudden increase in the intra-abdominal pressure leads to the perforation in the chronically deranged rectal wall and pushes the small bowel loops into the pelvis and through the perforated rectum to appear transanally.