Abstract
Rectal prolapse is the complete protrusion of the rectum through the anal canal. It is most common in elderly people, but can rarely occur at any age, the strangulated rectal prolapse is a rare complication. We report the case of a 78-year old men who underwent emergency surgery for strangulated rectal prolapse. Emergency perineal rectosigmoidectomy (Altemeier repair) was performed with simple outcome.
 This case highlights the importance of Altemeier’s procedure in the face of a strangulated rectal prolapse in an emergency situation.
Highlights
Rectal prolapse results in a rectal static disorder which involves rectal wall, intussusception inducing its externalization through the anus
Following the failure of external manual reduction and the appearance of established necrosis, we decided to perform an emergency surgery. He had undergone rectosigmoidectomy with colo-anal anastomosis by perineal route according to the Altemeier technique: the rectum was sectioned just above the pectine line, the colon lowered transanally was sectioned opposite the pectine line
The estimated prevalence of rectal prolapse in adults over 65 year old is 1%. It can be associated with significant morbidity including rectal bleeding, chronicle constipation, rectal pain and possible strangulation [3].There are many contributing factors: constipation, pregnancies, diastasis of the levators, redundant sigmoid colon, deep cul-de-sac, abnormal rectal angle, and lack of retroperitonealization of the rectum [4]
Summary
Rectal prolapse results in a rectal static disorder which involves rectal wall, intussusception inducing its externalization through the anus. The organ becomes edematous, and begins to ulcerate and gangrenous, requiring emergency surgery [1].The choice of surgical procedure depends mainly on patient’s age, clinical condition, surgical risk, coexisting functional symptoms, and the surgeon’s experience with a particular surgical approach [2] Case report It is a 78-year-old men admitted to the emergency department with a painful mass protruding through the canal anal evolving over five days. Following the failure of external manual reduction and the appearance of established necrosis, we decided to perform an emergency surgery He had undergone rectosigmoidectomy with colo-anal anastomosis by perineal route according to the Altemeier technique: the rectum was sectioned just above the pectine line, the colon lowered transanally was sectioned opposite the pectine line. The specimen pathophysiology examination revealed an inflammed mucosa with ulceration
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