Table Sugar as a Bridge from Emergency to Elective Perineal Proctosigmoidectomy for Incarcerated Rectal Prolapse

Dubai Medical Journal ◽

10.1159/000520605 ◽

2021 ◽

pp. 330-333

Author(s):

Melissa Kyriakos Saad ◽

Elias Saikaly

Keyword(s):

Rectal Prolapse ◽

Emergency Surgery ◽

Perineal Approach ◽

Emergency Presentation ◽

First Choice

Incarcerated rectal prolapse is a rare pathology and is considered an emergency, using table sugar can shift the emergency surgery to an elective one. If left untreated, rectal prolapse may present as an emergency, be it incarceration or strangulation. In an emergency presentation for incarcerated rectal prolapse every attempt should be taken to reduce the prolapsed rectum, if not successful, emergency surgery is indicated, with perineal approach being the first choice in elderly with multiple comorbidities.

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The Perineal Approach to Rectal Prolapse

Pelvic Floor Disorders ◽

10.1007/978-3-030-40862-6_67 ◽

2020 ◽

pp. 827-834

Author(s):

Alison Althans ◽

Anuradha Bhama ◽

Scott R. Steele

Keyword(s):

Rectal Prolapse ◽

Perineal Approach

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Strangulation of giant rectal prolapse

Scottish Medical Journal ◽

10.1177/0036933018764035 ◽

2018 ◽

Vol 63 (2) ◽

pp. 57-59 ◽

Cited By ~ 1

Author(s):

Imad El Moussaoui ◽

Augustin Limbga ◽

Manke Dika ◽

Abdelilah Mehdi

Keyword(s):

Rectal Prolapse ◽

Anal Canal ◽

Sigmoid Colon ◽

Successful Treatment ◽

Emergency Surgery ◽

Unusual Case ◽

Case Scenario ◽

Case Presentation ◽

Postoperative Course ◽

Spherical Mass

Introduction Rectal prolapse is the complete protrusion of the rectum through the anal canal, incarceration rarely complicates rectal prolapse. Even more rarely, it becomes strangulated and gangrenous, necessitating emergency surgery. Case presentation We present the first reported case of strangulated acute rectal prolapse as the first manifestation of rectal prolapse. The patient was a 26-year-old man who presented with a 20×6 cm semi-spherical mass extra-anally. Rectosigmoidectomy with sacral rectopexy was performed, resecting 20 cm of the incarcerated rectum and sigmoid colon. The postoperative course was uneventful with a good final result after colostomy closure and continuity restoration. Conclusion The successful treatment of this patient illustrates the value of surgery in this difficult and unusual case scenario of rectal incarceration.

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Evaluation of outcomes in elderly patients diagnosed with colorectal cancer

International Surgery Journal ◽

10.18203/2349-2902.isj20181101 ◽

2018 ◽

Vol 5 (4) ◽

pp. 1201

Author(s):

Neil Lawrence ◽

Joshua Griffiths ◽

Keith Chapple

Keyword(s):

Colorectal Cancer ◽

Operative Treatment ◽

Emergency Surgery ◽

Performance Status ◽

Significant Risk ◽

Distant Metastases ◽

The Elderly ◽

High Morbidity ◽

Tertiary Referral Centre ◽

Emergency Presentation

Background: Colorectal cancer in the elderly carries a high morbidity and mortality. The National Bowel Cancer Audit Programme is a high-quality audit incorporating all UK colorectal cancer patients. Author analysed this database to investigate the local outcomes for this high-risk group.Methods: Data (mode of presentation, presence of metastatic disease, treatment surgery, colonic stent or conservative and WHO performance status) was collected on all patients aged 85 years or over diagnosed with colorectal cancer at a large tertiary referral centre over a 5-year period. Ninety day and 2 year-mortality was obtained for all patients.Results: Ninety patients (45 male, 45 female, median age 88.9 range 85.0-97.9 years) were included (47 emergency presentation, 43 elective presentation). A 18 of 47 patients underwent emergency surgery. A 90-day and 2-year mortality in this group was 17% and 69% respectively. 29 of 47 patients presenting as an emergency had non-operative treatment (2-year mortality 87%). Two years mortality for patients undergoing emergency surgery was 100% if aged above 90 years or if distant metastases were present. Eleven of 43 patients presenting electively underwent surgery. 90-day and 2-year mortality for this group was 18% and 0% respectively. Two years mortality for those presenting electively and undergoing non-operative treatment was 62%.Conclusions: Decision making must be very carefully considered in patients aged over 85 years as the presence of metastases, poor WHO performance status or age over 90 carries with it a significant risk of mortality at both 90 days and 2 years following diagnosis.

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Surgery for Rectal Prolapse: Functional Outcome from the Perineal Approach — An Overview

Rectal Prolapse ◽

10.1007/978-88-470-0684-3_13 ◽

2008 ◽

pp. 103-106

Author(s):

Steven D. Wexner ◽

Amit Khanna

Keyword(s):

Rectal Prolapse ◽

Functional Outcome ◽

Perineal Approach

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Sex-related penile fracture with complete urethral rupture: A case report and review of the literature

Archivio Italiano di Urologia e Andrologia ◽

10.4081/aiua.2015.3.260 ◽

2015 ◽

Vol 87 (3) ◽

pp. 260 ◽

Cited By ~ 7

Author(s):

Marco Garofalo ◽

Lorenzo Bianchi ◽

Giorgio Gentile ◽

Marco Borghesi ◽

Valerio Vagnoni ◽

...

Keyword(s):

Case Report ◽

Emergency Surgery ◽

Tunica Albuginea ◽

Blunt Injury ◽

Penile Shaft ◽

Penile Fracture ◽

Voiding Symptoms ◽

First Choice ◽

The Right ◽

Urethral Rupture

Objective: To present the management of a patient with partial disruption of both cavernosal bodies and complete urethral rupture and to propose a non-systematic review of literature about complete urethral rupture. Material and method - Case report: A 46 years old man presented to our emergency department after a blunt injury of the penis during sexual intercourse. On physical examination there was subcutaneous hematoma extending over the proximal penile shaft with a dorsal-left sided deviation of the penis and urethral bleeding. Ultrasound investigation showed an hematoma in the ventral shaft of the penis with a discontinuity of the tunica albuginea of the right cavernosal corporum. The patient underwent immediate emergency surgery consisted on evacuation of the hematoma, reparation the partial defect of both two cavernosal bodies and end to end suture of the urethra that resulted completely disrupted. Results: The urethral catheter was removed at the 12-th postoperative day without voiding symptoms after a retrograde urethrography. 6 months postoperatively the patients was evaluated with uroflowmetry demonstrating a max flow rate of 22 ml/s and optimal functional outcomes evaluated with validated questionnaires. 8 months after surgery the patients was evaluated by dynamic magnetic resonance (MRI) of the penis showing only a little curvature on the left side of the penile shaft. Conclusion: Penile fracture is an extremely uncommon urologic injury with approximately 1331 reported cases in the literature till the years 2001. To best of our knowledge from 2001 up today, 1839 more cases have been reported, only in 159 of them anterior urethral rupture was associated and in only 22 cases a complete urethral rupture was described. In our opinion, in order to prevent long term complications, in case of clinical suspicion of penile fracture, especially if it is associated to urethral disruption, emergency surgery should be the first choice of treatment.

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