Related Experiment Videos
Paediatric rectal prolapse in Rwanda
E J Chaloner1, J Duckett, J Lewin
1Royal London Hospital, England.
Insights
In Rwandan refugee children, rectal prolapse linked to diarrhea, malnutrition, and worms was treated with a modified Thiersch wire technique. This method provided effective short-term control for prolapse cases.
Area of Science:
- Pediatric Surgery
- Gastroenterology
- Public Health in Crisis Situations
Background:
- A high incidence of full-thickness rectal prolapse occurred in Rwandan refugee children during the 1994 crisis.
- The prolapses were associated with acute diarrheal illness, malnutrition, and worm infestation.
Purpose of the Study:
- To evaluate the efficacy of a modified Thiersch wire technique for managing rectal prolapse in pediatric refugee populations.
- To provide immediate intervention for rectal prolapse under challenging humanitarian conditions.
Main Methods:
- A modified Thiersch wire technique involving a catgut pursestring around the anal margin was applied to 40 children.
- Procedures were performed under local, regional, or general anesthesia within a refugee camp setting.
- The intervention aimed for short-term prolapse control pending correction of underlying health issues.
Main Results:
- The modified Thiersch wire technique effectively controlled full-thickness rectal prolapse in the short term for all 40 patients.
- No complications were reported during the treatment period.
- A single case of recurrence was noted, with no formal follow-up possible.
Conclusions:
- The modified Thiersch wire technique offers a viable and safe short-term solution for rectal prolapse in pediatric populations facing severe health crises.
- This surgical approach can stabilize patients, allowing for management of contributing factors like malnutrition and infection.
Abstract:
During the 1994 crisis in Rwanda, a high incidence of full-thickness rectal prolapse was noted among the refugee children in the south-west of the country. The prolapses arose as a result of acute diarrhoeal illness superimposed on malnutrition and worm infestation. We used a modification of the Thiersch wire technique in 40 of these cases during two months working in a refugee camp. A catgut pursestring was tied around the anal margin under local, regional or general anaesthesia. This was effective in achieving short-term control of full-thickness prolapse until the underlying illness was corrected. Under the circumstances, no formal follow-up could be arranged; however, no complications were reported and only one patient presented with recurrence.