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Case series: Incarcerated massive rectal prolapse successfully treated with Altemeier's procedure
Xuan Hung Nguyen1, Phuc Khanh Pham1, Randolph M Steinhagen2
1Viet Duc University Hospital, 40 Trang Thi, Hoan Kiem, Hanoi, Viet Nam.
International Journal of Surgery Case Reports
|October 27, 2018
Summary
Perineal rectosigmoidectomy (Altemeier's procedure) is a safe and effective emergency treatment for incarcerated and necrotic rectal prolapse. Fecal diversion needs are determined by patient condition and surgeon judgment.
Area of Science:
- Colorectal Surgery
- Surgical Gastroenterology
Background:
- Incarcerated and necrotic rectal prolapse are rare but require urgent surgical intervention.
- Perineal rectosigmoidectomy (Altemeier's procedure) is a potential treatment option.
- Fecal diversion may be necessary in select cases.
Purpose of the Study:
- To evaluate the efficacy and safety of perineal rectosigmoidectomy for incarcerated and necrotic rectal prolapse.
- To review literature for optimal management strategies.
- To determine indications for fecal diversion.
Main Methods:
- Case report of two patients with incarcerated massive rectal prolapse, one with necrosis.
- Successful treatment with perineal rectosigmoidectomy.
- Literature review on management and fecal diversion.
Main Results:
- Both patients treated with perineal rectosigmoidectomy recovered uneventfully.
- One patient required a diverting colostomy.
- Literature supports Altemeier's procedure in emergency settings.
Conclusions:
- Perineal rectosigmoidectomy is a safe and effective emergency procedure for rectal prolapse.
- The decision for fecal diversion is surgeon-dependent and based on clinical factors.