Management of irreducible giant rectal prolapse: A case report and literature review

Introduction and importance Rectal prolapse is defined as herniation of mucosa or full-thickness of the rectal wall through the anal canal. It has a negative impact on the quality of life and therefore, it should be treated as soon as diagnosis is confirmed. Definitive treatment is surgical and it depends on the clinical characteristics of the patients. We aimed to present the one of the largest rectal prolapse case in the literature. Case presentation A 32- years- old male patient with a history of severe constipation was admitted to our institution with a giant rectal prolapse. The prolapsed segment was incarcerated, and a semi-emergent procedure was performed though a mid-line laparotomy. The sigmoid colon was redundant and therefore sigmoid colon and the upper two thirds of rectum were resected and end to end anastomosis was performed. The patient was discharged postoperative day 7 without any complication. Clinical discussion Rectal prolapse has a negative impact on quality of life and should be operated as soon as the diagnosis is reached. The surgical strategy depends on the compliance of the patient as well as the experience of the surgical team. Conclusion Clinicians should know that chronic constipation together with other factors may result in rectal prolapse which may become disproportionately large in size.
Highlights • Rectal prolapse (RP) is herniation of mucosa or full-thickness of the rectal wall through the anal canal. RP is classified in to three clinical subtypes: mucosal invagination, partial; internal, and full-thickness; external. • Prolapsed segment of rectosigmoid larger than 10 cm in length are defined as giant RP