Strangulated Rectal Prolapse in an Adult: A Case Report and Review of the Literature

Vollständiger Abstract

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Introduction: Strangulated rectal prolapse is a rare complication of complete rectal prolapse. Its course may be marked by necrosis, or even perforation, which requires prompt management. Case Report: A 44-year-old man with chronic constipation and a several-year history of episodes of reducible rectal prolapse was admitted with a large painful anal mass that had appeared suddenly after straining during defecation. On admission, he was hemodynamically stable. Proctological examination revealed a complete, large, edematous, painful, and irreducible rectal prolapse, without necrosis. After failure of manual reduction, an emergency perineal rectosigmoidectomy with coloanal anastomosis according to the Altemeier technique was performed. The postoperative course was uneventful. The patient resumed oral feeding on the first day and was discharged on the third postoperative day. At six months, no recurrence was observed and the functional outcome was satisfactory. Conclusion: Strangulated rectal prolapse is a surgical emergency because of the risk of necrosis. In a stable patient without peritonitis, perineal rectosigmoidectomy according to Altemeier is an appropriate therapeutic option.