Abstract
A 64-year-old man who suffered from anal prolapse 10 years previously was found to have internal hemorrhoids for which manual reduction was performed by the patient. In December 2013, he noted rectal prolapse after defecation, but he could not reduce the lesion. At 20 hours after the onset, he was admitted because of severe pain and bleeding. We diagnosed incarcerated rectal prolapse, but an attempt at reduction under lumbar anesthesia failed. Because the mucosal color and edema were becoming worse and necrotic change was suspected, emergency perineal rectosigmoidectomy using Altemeier’s procedure and ileostomy with mini-laparotomy were performed under general anesthesia. Pathological findings showed diffuse necrotic change extending from the rectal mucosa to the muscle layer. Postoperatively, he recovered rapidly without any complications, and underwent closure of ileostomy 2 months later. We herein report a case of incarcerated rectal prolapse successfully treated by emergency perineal rectosigmoidectomy, with a review of the literature.
