Case series: Incarcerated massive rectal prolapse successfully treated with Altemeier’s procedure

Nguyễn, Xuân Hùng; Pham, Phuc Khanh; Steinhagen, Randolph; Pham, Gia Anh; Le, Nhat Huy; Nguyen, Ngoc Anh

doi:10.1016/j.ijscr.2018.08.057

Cited by 9 publications

(10 citation statements)

References 9 publications

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“…For rectal prolapse greater than 4 cm Altemeier approach is preferred whereas for prolapse with a short segment of bowel Delorme procedure can be performed [6] . A few case studies have described a similar clinical presentation, however, it has never been described in the case of rectal adenocarcinoma prolapsing from the anus, making this case unique [7] , [8] , [9] , [10] , [11] . Each of these studies performed an Altemeier rectosigmoidectomy for resection of the necrotic segment of bowel.…”

Section: Discussionmentioning

confidence: 76%

The utility of the Altemeier procedure in strangulated rectal procidentia secondary to rectal cancer. A case report

Chase¹,

Griffith

Doyle³

2022

International Journal of Surgery Case Reports

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Introduction and importance Altemeier rectosigmoidectomy has been cited in the literature as a suitable approach for incarcerated rectal prolapse when a large segment of bowel is involved. However, the literature is devoid of cases that employed the technique as an oncological procedure for rectal carcinoma. For this reason, this case report heralds a new perspective on an old technique. Case presentation We describe the case of a male in his 6th decade who presented with stage four rectal cancer. Computed tomography imaging showed a rectal mass at the rectosigmoid junction with pelvic lymphadenopathy and a solitary hepatic lesion in segment two of the liver. While admitted to the hospital a 16 cm segment of bowel containing the mass prolapsed and became incarcerated, eventually becoming necrotic. A modification of the Altemeier procedure was performed along with a diverting ileostomy and hepatic wedge resection of the solitary metastases. Histological assessment of the surgical specimens confirmed that adequate resection margins were obtained with one of twenty-one lymph nodes positive for malignancy. He is currently being followed up in the outpatient oncology clinic and has commenced adjuvant chemotherapy. Clinical discussion Synchronous excision of rectal carcinoma with hepatic metastasectomy is a feasible surgery even in the emergency setting and can offer improved patient survival. Conclusion The combination of both an abdominal and perineal approach was suitable for this patient given his improved quality of life and negative pathological margins.

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Section: Discussionmentioning

confidence: 76%

The utility of the Altemeier procedure in strangulated rectal procidentia secondary to rectal cancer. A case report

Chase¹,

Griffith

Doyle³

2022

International Journal of Surgery Case Reports

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“…However, surgical management is the only definitive treatment that can improve quality of life and bowel function [ 4 ]. When a rectal prolapse is irreducible, whether there is necrosis or not, immediate surgical repair is required [ 8 ]. In this case, there was an irreducible, large rectal prolapse with a length of 10 cm and multiple lacerations.…”

Section: Discussionmentioning

confidence: 99%

A 54-Year-Old Man with a Large Rectal Prolapse Treated with Perineal Proctosigmoidectomy with Levatorplasty (Altemeier Procedure): Presentation of Case and Review of Literature

2023

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Objective:Rare disease Background:The surgical procedure of perineal proctosigmoidectomy with levatorplasty is known as the Altemeier procedure. This report presents the case of a 54-year-old man with a large rectal prolapse treated with perineal proctosigmoidectomy with levatorplasty (Altemeier procedure). Case Report:A 54-year-old male had a large bulging in the rectum since 5 months ago. At first, the bulging was small, but its size had increased to approximately 10 cm at presentation. The patient also stated that the bulging used to reduce spontaneously after defecating or manually by applying sufficient pressure, but lately it had been irreducible. Another concern was chronic constipation over the last few years, which was treated with over-thecounter laxatives and stool softeners. Physical examination of the perianal region revealed a full-thickness, irreducible, prolapsed bowel segment, approximately 10 cm long, with multiple mucosal ulcerations. Grade V rectal prolapse was diagnosed. Follow-up at 7, 14, and 30 days after surgery showed complete resolution of symptoms and no recurrence. Conclusions:Individually tailored and prompt surgical treatment for all patients with rectal prolapse is vital. The Altemeier procedure, which has good efficacy with low morbidity, complications, and recurrence, should be considered in elderly patients with an irreducible, large rectal prolapse.

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“…Perineal proctosigmoidectomy, also known as Altemeier's procedure is one of the popular techniques in the emergency setting for almost all patients with acceptable outcomes [ 4 , 12 , 13 ]. Also, a temporary diversional loop such as ileostomy or colostomy can be considered for patients to ensure the excellence of anastomosis healing due to the surgeon's judgments [ 14 ].…”

Section: Discussionmentioning

confidence: 99%

A case report of largest rectal prolapse in the literature successfully treated with Altemeier's procedure

Ahmadinejad¹,

Farsi

bahr³

et al. 2022

Annals of Medicine &Amp; Surgery

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Case series: Incarcerated massive rectal prolapse successfully treated with Altemeier’s procedure

Cited by 9 publications

References 9 publications

The utility of the Altemeier procedure in strangulated rectal procidentia secondary to rectal cancer. A case report

The utility of the Altemeier procedure in strangulated rectal procidentia secondary to rectal cancer. A case report

A 54-Year-Old Man with a Large Rectal Prolapse Treated with Perineal Proctosigmoidectomy with Levatorplasty (Altemeier Procedure): Presentation of Case and Review of Literature

A case report of largest rectal prolapse in the literature successfully treated with Altemeier's procedure

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