Emergency Altemeier’s Operation for Strangulated Rectal Prolapse: A Case Report

Abstract

Introduction: Rectal prolapse is defined as the protrusion of the rectal wall through the anal canal. Most rectal prolapses are reduced spontaneously, or the patient can reduce them manually. On rare occasions, the prolapsed segment cannot be reduced, leading to secondary complications like incarceration and strangulation. Emergency surgical intervention becomes mandatory when an ischemic complication occurs.
Case report: We report a case of a 45-year-old male who presented with a painful and irreducible rectal prolapse. The prolapsed rectum was large, incarcerated, and the mucosa looked gangrenous. Emergency surgery was performed using Altemeier’s procedure. This surgical procedure consists of total resection of the prolapsed rectum and colon. Then colo-anal anastomosis was done in the same sitting. A covering loop sigmoid colostomy was done to ensure the uncomplicated healing of edematous bowel. Sigmoid colostomy was closed 3 months after the procedure. The bowel continuity was confirmed by barium enema before closure of colostomy. This case illustrates the successful management of a challenging case of rectal prolapse with gangrene of bowel.