A different approach to incarcerated and complicated rectal prolapse

Area of Science:

• Gastroenterology
• Colorectal Surgery
• Surgical Innovation

Background:

• Rectal prolapse, a condition where the rectum protrudes through the anus, predominantly affects women over 50.
• It can range from mucosal lining protrusion to full-thickness rectal and sigmoid colon involvement.
• Incarcerated rectal prolapse with sigmoid colon perforation is a rare, high-risk surgical emergency.

Observation:

• A case of incarcerated rectal prolapse with sigmoid colon perforation was successfully managed.
• A modified perineal resection technique was employed, suitable for emergency department settings in elderly, comorbid patients.
• The procedure utilized loco-regional or spinal anesthesia, minimizing operative risks.

Findings:

• The perineal resection technique effectively addressed the incarcerated rectal prolapse and sigmoid colon perforation.
• The chosen anesthesia (spinal) reduced operative risks and facilitated defect correction.
• The patient experienced an uncomplicated recovery and was discharged within seven days.

Implications:

• This perineal resection technique provides a safe and effective emergency treatment for large incarcerated rectal prolapse.
• The method allows for anatomical reconstruction and the use of spinal anesthesia, improving patient outcomes.
• It offers a single-stage solution, potentially reducing the need for re-operation in high-risk patients.