Wilson Disease (W ) is a rare inborn disorder of cooper metabolism. In approximately 40% of cases signs and symptoms of abnormal liver functions are observed due to hepatic inflammation, cirrhosis or insufficiency. The mainstay treatment is the conservative treatment with zinc (eg Zincteral) or penicillamine. The Authors present a patient with WD who underwent surgery because of an advanced rectal prolapse (laparotomy, rectal mobilization, rectopexy, the partial sigmoid colon resection with the primary anastomosis). The postoperative course was complicated by anastomotic leakage and a subsequent diffuse peritonitis. The patient required relaparotomy and three weeks treatment in the intensive therapy unit. The Authors consider the WD as a significant risk factor for surgical patients. Surgical treatment of patients with WD should be least invasive.