Man Suffers Rare Evisceration After Hernia Surgery

An elderly man found himself in a dire situation when his colon unexpectedly protruded from his abdomen after a common surgical procedure. The 83-year-old underwent a hernia repair, which led to what is known as “spontaneous evisceration” of his small intestine.

In this unusual case, over three feet of his small intestine pushed through a two-inch opening in his skin due to the hernia—a condition where part of an organ bulges through weak muscle or tissue. Additionally, the twisted bowel restricted vital blood flow, complicating matters even further.

While bowel evisceration is uncommon, hernias impact around five million people annually in the U.S., and more than a million hernia repairs are done each year, making it one of the most frequent types of surgery. Oddly enough, similar instances have occurred where patients experienced bowel evisceration due to excessive coughing or trauma like a knife wound.

Interestingly, the Romanian man’s doctors revealed he had no significant history of coughing fits or any trauma, though he had dealt with several hernias over time. Medical literature documents fewer than 100 cases of evisceration, with instances like this man’s only observed a handful of times, according to his medical team.

In a medical journal, the doctors noted: “Evisceration of intra-abdominal organs is a rare, serious event.” It’s usually caused by traumatic injuries or sudden increases in abdominal pressure from coughs or heavy lifting, which can compromise the abdominal lining’s integrity and protection.

Facing complications, the man, who is also a rectal cancer survivor, had a hernia near his stoma—a surgical opening that allows waste to exit into a collection bag. Remarkably, he had undergone a repair for another similar hernia just two years before this incident.

Surgeons usually address a hernia by repositioning the tissue and sealing the weak area in the abdominal wall. After realizing the severity of the man’s condition, he was transferred to a specialized hospital in Romania. It had been six hours since his intestine had initially burst by the time he arrived.

Thankfully, although the situation was critical, he remained conscious and alert throughout the ordeal. In surgery, doctors connected the remaining portion of his small intestine to the colon and corrected the stoma operation.

He managed to leave the hospital eight days post-surgery. The medical team noted that cases of spontaneous evisceration from a parastomal hernia are exceedingly rare, primarily reported in patients with a history of rectal cancer who have undergone colostomy and often due to severe coughing.

For instance, a 2012 case involved a 62-year-old from Turkey, who experienced severe abdominal bloating and vomiting leading to evisceration around his colostomy site, marking one of the first documented cases of this type.