Rectal prolapse and abdominal compartment syndrome: Formerly unknown complications of hernia repair in a neonate

Abstract

Rectal prolapse, a troublesome diagnosis in children, can be associated with anatomic anorectal abnormalities among other pathologies, including parasitic infestations, cystic fibrosis, and constipation, but the precise mechanism remains unknown [1]. Abdominal compartment syndrome (ACS), however, is a potentially lethal complication in the pediatric population, with estimated case fatality rate of approximately 50% [2]. While cases of both rectal prolapse and ACS have been described in the pediatric surgical literature, occurrences of such diagnoses following inguinal hernia repair in infants have not been documented previously. Here we describe the unique hospital course of an infant with trisomy 21 who underwent two sequential inguinal hernia repairs, the first complicated by rectal prolapse, the second by ACS. • Rectal prolapse is a previously unknown acute complication of inguinal hernia repair in infants. • Abdominal compartment syndrome (ACS) is also a previously unknown complication of inguinal hernia repair in infants. • Future patients with tissue laxity may be better served by general anesthesia than spinal anesthesia.