Improvement of Rectal Prolapse Using an Over-the-scope Clip System

Area of Science:

• Gastroenterology
• Colorectal Surgery
• Endoscopic Therapeutics

Background:

• Rectal prolapse management typically involves surgical intervention.
• Endoscopic therapies for rectal prolapse have not been previously reported.
• An 81-year-old female presented with anorectal pain and observed rectal prolapse.

Observation:

• During colonoscopy, an attempt at endoscopic reversal of rectal prolapse resulted in rectal perforation.
• The over-the-scope clip (OTSC) system was utilized to manage the rectal perforation.
• Following OTSC application, significant improvement in the patient's rectal prolapse was noted.

Findings:

• The OTSC system successfully closed the rectal perforation.
• Rectal prolapse resolution is hypothesized to be due to the rectal wall being anchored to the retroperitoneum.
• This case demonstrates the first reported instance of endoscopic improvement for rectal prolapse.

Implications:

• The over-the-scope clip (OTSC) system presents a potential endoscopic alternative for rectal prolapse treatment.
• This method may be particularly beneficial for patients with inoperable rectal prolapse.
• Further research is warranted to validate the efficacy and safety of endoscopic OTSC application for rectal prolapse.