Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2018:51:309-312.
doi: 10.1016/j.ijscr.2018.08.057. Epub 2018 Sep 5.

Case series: Incarcerated massive rectal prolapse successfully treated with Altemeier's procedure

Xuan Hung Nguyen  1 , Phuc Khanh Pham  2 , Randolph M Steinhagen  3 , Gia Anh Pham  4 , Nhat Huy Le  5 , Ngoc Anh Nguyen  6
Affiliations

Case series: Incarcerated massive rectal prolapse successfully treated with Altemeier's procedure

Xuan Hung Nguyen et al. Int J Surg Case Rep. 2018.

Abstract

Introduction: Incarceration and necrosis of rectal prolapse is rare but when it occurs it requires urgent management. Perineal rectosigmoidectomy (Altemeier's procedure) may be a reasonable approach for the treatment of this condition. In some cases, a diverting stoma may be necessary.

Methods: We report two cases of incarcerated massive rectal prolapse, one of which also manifested tissue necrosis, that were successfully treated with perineal rectosigmoidectomy. In one case a diverting colostomy was required. Both patients recovered uneventfully.

Results: A literature review was performed to determine the optimal management of incarcerated and necrotic rectal prolapse, and to determine the indication for fecal diversion.

Conclusion: Perineal rectosigmoidectomy (Altemeier's procedure) can be utilized in emergency circumstances and, in our experience, the procedure was both safe and effective. The need for fecal diversion depends on the condition of the patient and the experience and judgement of the surgeon.

Keywords: Altemeier’s procedure; Incarceration; Perineal rectosigmoidectomy; Rectal prolapse.

PubMed Disclaimer

Figures

Fig. 1
Fig. 1
Patient 69-year-old male treated by Altemeier’s procedure without colostomy.
Fig. 2
Fig. 2
Patient 52-year-old male treated by Altemeier’s procedure with temporary colostomy diversion.
Fig. 3
Fig. 3
CT scanner image of full-thickness massive rectal prolapse.
See this image and copyright information in PMC

References

    1. Agha R.A., Fowler A.J., Rammohan S., Barai I., Orgill D.P., the PROCESS Group The PROCESS statement: preferred reporting of case series in surgery. Int. J. Surg. 2016;36(PtA):319–323. - PubMed
    1. Kairaluoma M.V., Kellokumpu I.H. Epidemiologic aspects of complete rectal prolapse. Scand. J. Surg. 2005;94(3):207–210. - PubMed
    1. Marceau C., Parc Y., Debroux E., Tiret E., Parc R. Complete rectal prolapse in young patients: psychiatric disease a risk factor of poor outcome. Colorectal Dis. 2005;7(4):360–365. - PubMed
    1. Mitchell N., Norris M.L. Rectal prolapse associated with anorexia nervosa: a case report and review of the literature. J. Eat. Disord. 2013;1:39. - PMC - PubMed
    1. Deen K.I., Grant E., Billingham C., Keighley M.R. Abdominal resection rectopexy with pelvic floor repair versus perineal rectosigmoidectomy and pelvic floor repair for full-thickness rectal prolapse. Br. J. Surg. 1994;81(2):302–304. - PubMed