Altemeier Operation for Recurred and Strangulated Rectal Prolapse

Abstract

Strangulation of an acute rectal prolapse is a rather unusual entity that represents a surgical emergency. We describe an extremely rare case of recurred, incarcerated, and strangulated acute rectal prolapse. The patient underwent emergency perineal rectosigmoidectomy (the Altemeier operation). The postoperative course was uncomplicated with an excellent final result.

Long-term outcome of perineal rectosigmoidectomy for rectal prolapse

“…When untreated, the prolapse may be associated with rare but serious complications such as incarceration and/or strangulation which can occur after years of complaint or even as first clinical presentation [2,7,[25][26][27]. Initial treatment is to attempt reduction of this prolapse, and if not successful, it is necessary to perform an emergency surgery, having as first choice the perineal approach [2,6,26,27]. The complete prolapse is associated with a four-fold increase in the relative risk of developing colorectal cancer, however there is no causal effect [7].…”

A retrospective study of rectal prolapse in Chitwan Medical College

“…No technique has proved its superiority over the other. 3 A wide spectrum of operative procedure is available for the management of rectal prolapse and can be done either abdominal or perineal approach. 4,5 The aim of surgery is an anatomical repositioning of the bowel and improvement of function of anorectal complex.…”

Prolapsus rectal étranglé de l’adulte jeune: à propos d’un cas et revue de la littérature

“…En situation d’urgence, seule la résection recto-sigmoïdienne par voie périnéale ou procédé d’Altemeier peut être proposée avec ou sans colostomie [ 2 ]. L’intervention de Delorme est difficile dans cette situation à cause de l’œdème et elle est contre indiquée en cas de nécrose [ 6 ]. La morbidité post opératoire immédiate pour l’intervention d’Altemeier, réalisée en urgence, est quasiment nulle avec un très faible risque de lâchage anastomotique [ 7 ].…”