Eviscération transanale de l´intestin grêle par empalement chez l´enfant: à propos d´un cas

Transanal evisceration of the small intestine caused by impalement is exceptional among children. We report the case of an 11-year old girl with intestinal loops eviscerating through the anus due to a fall on a sharp piece of wood which stuck into her, occurring two hours before hospitalization. On examination, his general condition was good, with transanal evisceration of approximately 25 cm of viable small bowel through the anus and abdominal tenderness. Preoperative laboratory tests were normal and no imaging test was performed. After resuscitation, surgical exploration was performed which showed serohematic fluid collection (300 ml) and evisceration of approximately 60 cm of inflammated intestinal loops through a rupture of approximately 5 cm of the anterior wall of the rectum. Reduction of the eviscerated intestinal loops by gentle traction, repair of the rectal wall by separated sutures, wash and drainage were performed. The patient received broad-spectrum antibiotic. The operating suites were simple with a resumption of transit two days after surgery. The patient was discharged seven days after surgery. After a follow-up period of one month, the patient came for a further consultation and clinical examination was normal.