Acute transanal ileal evisceration

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.