A 72-year-old lady presented with prolapsed loops of small bowel through the anus without any history of local trauma or instrumentation. The event followed excessive straining during defecation. Exploratory laparotomy revealed a deep pouch of Douglas, and rent on the anterior wall of the rectum, through which the bowel had prolapsed. The eviscerated small gut was reduced after proper cleansing and the rent on the rectal wall repaired without diverting colostomy. The patient had an uneventful recovery
