Strangulation of giant rectal prolapse

Abstract

Introduction Rectal prolapse is the complete protrusion of the rectum through the anal canal, incarceration rarely complicates rectal prolapse. Even more rarely, it becomes strangulated and gangrenous, necessitating emergency surgery. Case presentation We present the first reported case of strangulated acute rectal prolapse as the first manifestation of rectal prolapse. The patient was a 26-year-old man who presented with a 20×6 cm semi-spherical mass extra-anally. Rectosigmoidectomy with sacral rectopexy was performed, resecting 20 cm of the incarcerated rectum and sigmoid colon. The postoperative course was uneventful with a good final result after colostomy closure and continuity restoration. Conclusion The successful treatment of this patient illustrates the value of surgery in this difficult and unusual case scenario of rectal incarceration.

Incarcerated rectal prolapse resolved by the Altemeier procedure. About a case

“…El prolapso rectal encarcelado es raro, constituye una urgencia de resolución quirúrgica (2,3) . El procedimiento de Altemeier, es una técnica bien tolerada para pacientes añosos o con múltiples comorbilidades, se realiza en un solo tiempo y tiene menos complicaciones que el abordaje laparotómico (1,5) , la más grave es la dehiscencia de anastomosis coloanal, descripto con poca frecuencia (7) .…”

“…El prolapso rectal encarcelado es raro descripto en menos del 1 % de los casos de prolapso rectal completo, y ocurre en pacientes con síntomas de larga duración (2) . Constituye una urgencia quirúrgica por el riesgo de necrosis y ulceración de la mucosa, con posterior ruptura de la misma, con evisceración de asas delgadas (3,6) .…”

Incarcerated complete rectal prolapse managed by Altemeier’s procedure

“…2 Rectal incarceration may progress to strangulation, which is life-threatening, but may be the first presentation. 3 Although > 100 operative procedures have been described for the treatment of rectal prolapse, the options are limited in a case of incarceration and strangulation.…”