The Altemeier Procedure in the Management of Rectal Prolapse Secondary to a Prolapsed Rectal Polyp: A Valid Alternative.

Abstract

The definition of rectal prolapse is the protrusion of the rectal wall through the anal canal. The diagnosis of this condition is primarily clinical, based on the patient's symptoms and physical examination findings. Most rectal prolapses can be reduced spontaneously, or the patient can manually reduce them. On rare occasions, the prolapsed segment cannot be reduced, leading to secondary complications, such as severe pain, bleeding, strangulation, and even perforation. Its management is primarily surgical, and the choice of technique varies according to the severity of the condition, the symptoms presented, available resources, and the preferences of the patient and surgeon. We present a case of a 67-year-old female patient with a history of a rectal polyp, who sought consultation for rectal bleeding and rectal prolapse. A giant rectal polyp was documented as the main cause of the prolapse, which was managed surgically with a perineal rectosigmoidectomy (Altemeier procedure). The pathological finding confirmed a giant adenomatous polyp with no evidence of malignancy. The patient had a favorable postoperative evolution.