{Reference Type}: Case Reports {Title}: A case of small bowel evisceration through the rectum and anus. {Author}: Farrugia A;Sarma D;Mobarak D; {Journal}: Br J Hosp Med (Lond) {Volume}: 85 {Issue}: 7 {Year}: 2024 Jul 30 {Factor}: 1.286 {DOI}: 10.12968/hmed.2024.0043 {Abstract}: A 46-year-old man presented with a small bowel prolapsing through the anus after straining on the toilet, which was starting to become ischaemic. He admitted to inserting a plastic object in his rectum about half an hour before straining. The bowel was kept moist by placing an intravenous drip line with saline dripping onto a wet swab. In theatre, the bowel was found to be prolapsing through a hole in the upper rectum and out through the anus. It was reduced back into the abdominal cavity through the same perforation, which was 4 cm long, without needing to extend it. This was sutured with polydioxanone (PDS) 2-0 as there was no contamination with faeces or pus. Due to improvement in the appearance of a small bowel and an extremely bruised mesentery, a re-look was planned in 24 hours. At the re-look the small bowel appeared healthy, therefore no resection was performed. However, a loop colostomy was fashioned to protect the upper rectal perforation repair. This shows that resection is not always required in such cases.