Bhopal. In a remarkable medical case, Dr. Krishna Kumar, Assistant Professor from the All-India Institute of Medical Sciences (AIIMS) Bhopal successfully treated a rare case of strangulated complete rectal prolapse in a 39-year-old male. This extraordinary case stands out due to the rarity of such conditions in younger men, marking a significant milestone in medical management.

Rectal prolapse, typically seen in elderly women, is an uncommon condition where the rectal wall protrudes through the anus. It affects an estimated 2.5 per 100,000 people, with a female-to-male ratio of 10:1. Cases involving strangulation—where blood supply to the prolapsed tissue is compromised—are even more uncommon, occurring in just 2-3% of cases and requiring immediate surgical intervention.

The patient, who had a four-year history of reducible rectal prolapse, presented to AIIMS Bhopal's emergency department with a 12-hour history of an irreducible and strangulated prolapse. Following a thorough examination, including prior MRI imaging that confirmed a second-degree full-thickness rectal prolapse, an emergency perinealproctosigmoidectomy (Altemeier’s procedure) was performed. The surgery successfully resected the prolapsed bowel and restored pelvic floor function through levatorplasty.

Under the leadership of Dr. (Prof.) Ajai Singh and with the surgical expertise of Dr. BharatiPandya, Dr. Manish Swarnkar, and their team, the patient made a swift recovery. He regained full continence by the fourth day and was discharged without complications on the fifth day. A six-month follow-up showed no recurrence, with the patient maintaining full faecal continence.

This case highlights the importance of timely intervention in strangulated rectal prolapse and sets a precedent for handling similar emergencies. Dr. Krishna Kumar presented this case at the International Conference in Seoul (September 3-5, 2023), where it received significant recognition for its rarity and successful surgical management.

AIIMS Bhopal