Rarely a segment of prolapsed colon may strangulate and infarct.
Patient selection: rectal prolapse
Patient age: often older adult but sometimes pediatric patients
Mechanism: strangulation of the prolapsed segment with ischemia of bowel wall
Clinical presentation:
(1) perineal mass
(2) rectal pain
(3) infection
(4) incontinence
Complications may include:
(1) rectal gangrene
(2) septic shock
(3) bowel perforation
(4) prolapse or evisceration of other organs
Management may involve an emergency Altemeier operation (perineal proctosigmoidectomy with or without diverting colostomy. Less often Hartmann's procedure may be performed.
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