Jadhav Kavita, Gandhi Ami, Waghmare Rukmini, Sidam Dhanashri, More Shubham
General Surgery, Grant Government Medical College and Sir J.J. Group of Hospitals, Mumbai, IND.
Cureus. 2025 Mar 25;17(3):e81206. doi: 10.7759/cureus.81206. eCollection 2025 Mar.
Full-thickness rectal prolapse is a condition where the rectum or rectosigmoid protrudes through the anus. This condition can severely impact quality of life, requiring accurate diagnosis and treatment. Small bowel involvement is rare. This case report presents a 26-year-old male patient with complete rectal prolapse that could not be reduced through conservative management. Due to the irreducibility of the prolapse, even under spinal anesthesia, Altemeier's repair was ultimately performed. During surgery, loops of the small intestine were found along with the prolapsed segment of the rectum and sigmoid colon. Surgical management of rectal prolapse includes abdominal approaches such as laparoscopic or open ventral mesh rectopexy for a carefully selected subset of younger patients and perineal approaches such as Delorme's and Alteimeier's for elderly patients. In this case, despite the patient's young age, Altemeier's procedure was chosen due to the irreducibility of the prolapse. This case highlights the necessity of tailored surgical approaches for rectal prolapse. Individualized patient care and thorough evaluation of surgical options are crucial in managing this condition, ensuring the best possible patient outcomes.
全层直肠脱垂是指直肠或直肠乙状结肠经肛门脱出的一种病症。这种病症会严重影响生活质量,需要准确的诊断和治疗。小肠受累情况罕见。本病例报告介绍了一名26岁男性患者,患有完全性直肠脱垂,经保守治疗无法回纳。由于脱垂无法回纳,即使在脊髓麻醉下,最终还是进行了Altemeier修补术。手术过程中,发现脱垂的直肠和乙状结肠段伴有小肠袢。直肠脱垂的手术治疗包括腹部手术,如针对精心挑选的部分年轻患者进行腹腔镜或开放式腹侧网状直肠固定术,以及针对老年患者的会阴手术,如Delorme手术和Altemeier手术。在本病例中,尽管患者年轻,但由于脱垂无法回纳,还是选择了Altemeier手术。该病例凸显了直肠脱垂采用个性化手术方法的必要性。个体化的患者护理以及对手术方案的全面评估对于处理这种病症至关重要,可确保患者获得最佳预后。