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A different approach to incarcerated and complicated rectal prolapse.

BACKGROUND
Rectal prolapse is an intussusception of the rectum through the anal canal. The extent of the prolapse varies from the rectal mucosa to the full thickness of the rectum and sigmoid colon. It usually appears after 50 years of age, with a female predominance of over 80-90% of cases.


CASE REPORT
A rare case of incarcerated rectal prolapse with sigmoid colon perforation is reported. A different approach for large incarcerated rectal prolapse was used that can easily be performed in the emergency department in comorbid elderly patients. In emergent conditions, comorbid diseases of the patient increase the risk of mortality. Perineal resection allowed using loco-regional anesthesia. Perineal resection was safely applied and uncomplicated. Spinal anesthesia decreases the risk of operation and at same time allows correction of the main defect. After this operation there is no need for a second attempt. The patient was discharged seven days after the operation.


CONCLUSIONS
The perineal resection technique used in this case has two distinctive features: it reconstructs the pathology as closely as possible to its original anatomical condition and allows the use of spinal anesthesia.