A 46-year-old man presented with a small bowel prolapsing through the anus after straining on the toilet, which was starting to become ischaemic. He admitted to inserting a plastic object in his rectum about half an hour before straining. The bowel was kept moist by placing an intravenous drip line with saline dripping onto a wet swab. In theatre, the bowel was found to be prolapsing through a hole in the upper rectum and out through the anus. It was reduced back into the abdominal cavity through the same perforation, which was 4 cm long, without needing to extend it. This was sutured with polydioxanone (PDS) 2-0 as there was no contamination with faeces or pus. Due to improvement in the appearance of a small bowel and an extremely bruised mesentery, a re-look was planned in 24 hours. At the re-look the small bowel appeared healthy, therefore no resection was performed. However, a loop colostomy was fashioned to protect the upper rectal perforation repair. This shows that resection is not always required in such cases.

Background: Rectal prolapse is a circumferential, full-thickness protrusion of the rectum through the anus, which, if not properly managed, may become incarcerated and pose a risk of strangulation. This pathology is rarely a medical emergency unless a complication is encountered. Such complications include infection, necrosis, perforation, incarceration, and uncontrolled pain. Case Presentation: We report a case of an elderly patient with pain associated with chronic rectal prolapse. Surgical intervention had been ruled out, and there had been no pain relief after using systemic analgesics. Case Management: Based on increasing reports of analgesic properties, topical methylene blue (MB) 0.1% was applied externally at the prolapsed organ, obtaining pain relief. Case Outcome: The patient experienced immediate and long-lasting pain relief; MB applications were continued every 12 hours as needed. After this therapy, the patient was no longer in need of systemic analgesics. No side effects were reported. Conclusion: Topical MB may be an effective analgesic for the management of pain associated with chronic rectal prolapse. This treatment might be extrapolated to other clinical scenarios of tegumentary pain. Similar use has been shown to be safe and effective in other pathologies, including pain in oral mucositis associated with cancer therapy.

UNASSIGNED: Ilea caecum Intussusception protruding to the level of anus is a rare manifestation and potentially serious condition in infants.
METHODS: A four-month-old infant presented with a one-day history of non-projectile vomiting, three episodes, food contents, worsened by feeding, accompanied by intermittent low-grade fever, and one instance of passing black tarry stool. After outpatient treatment, the infant showed improvement for three days, but later the mother noticed a protruding, self-reducing anal mass, hence the suspected rectal prolapse, which was then Referred for further management.
UNASSIGNED: Intussusception, the most frequent surgical emergency in infants and young children aged 3 to 6 months, is primarily idiopathic, with the ileocecal region being the most commonly affected (90 % of cases). However, when the intussusceptum advances to the anus, it\'s rare, often leading to misdiagnosis and mismanagement.
CONCLUSIONS: Intussusception of the colon should be added to the differential diagnosis of symptoms and the clinical picture of rectal prolapse.

Rectosigmoid solitary juvenile polyps are benign lesions, relatively frequent in childhood. The clinical debut of a pediatric polyp with bleeding is relatively frequent, but there are very few reports of rectal prolapse of polyps. We present the case of a 7-year-old female patient with no previous history who presented with rectal prolapse of a polyp with acute bleeding. An urgent endoscopic examination was performed and 2 rectosigmoid polypoid lesions were found and resected. The anatomopathological study showed that these were 2 hamartomatous polyps with mild dysplasia. The patient is asymptomatic and is being followed up. The literature concerning rectal prolapse of polyps in the pediatric population is scarce. In a pediatric patient with a rectal prolapse, this entity should be considered in the differential diagnosis.

BACKGROUND: Rectal prolapse arises from benign etiology. When symptoms of internal intussusception mirror those of rectal prolapse, a misdiagnosis is possible, especially under limited clinical presentation. It is crucial to recognize and differentiate rectal prolapse from internal intussusception because the two diagnoses have different prognoses. Here, we describe a case of adult sigmoid intussusception presenting as rectal prolapse.
METHODS: A 64-year-old woman with no known medical history visited a gastrointestinal outpatient department due to hard bloody stool defecation for 1 wk followed by constipation for 3 d. Colonoscopy revealed a huge polypoid ulcerated tumor at the sigmoid colon with lumen stenosis. The patient was admitted due to post-procedural dull abdominal pain. Due to failed colonoscopy reduction and stent insertion, the patient underwent sigmoid colon resection with primary end-to-end anastomosis, with the transverse colostomy pathological report showing adenocarcinoma, pT3N0M0. She recovered well from the operation and was discharged with regular outpatient clinic follow-up.
CONCLUSIONS: Presentation and manifestation of sigmoid intussusception may resemble that of rectal prolapse, necessitating careful observation due to distinct prognostic implications.

BACKGROUND: Transanal small bowel evisceration remains a rarely recorded emergent situation in the scientific literature. This article describes the rather seldom complication of a non-treated long standing rectal prolapse presenting in the form of transanal prolapse of the small bowel due to rectal perforation.
METHODS: We present the case of an 84 year old female, who presented to our emergency department with transanal evisceration of the small bowel.
CONCLUSIONS: This rare case presentation led us to perform an accompanying review of the literature, using Pubmed® searching for the words \"transanal evisceration\", \"rectal prolapse\", and \"rectal perforation\". We discuss the outcomes of our literature review, possible pathogenesis and the available treatment options.
CONCLUSIONS: Although transanal evisceration of small bowel presents a rare emergency, having the knowledge of this condition would help early recognition of this incidence and hopefully lead to early treatment, which would avoid drastic consequences as a result of small bowel strangulation.

UNASSIGNED: Strangled rectal prolapse (RP), also known as incarcerated rectal prolapse, is a condition where the RP cannot be manually reduced.
METHODS: This case report describes a 48-year-old man presenting with a painful and irreducible rectal prolapse. Following failed attempts at manual reduction and the development of necrosis, emergency surgery was performed using the Altemeier procedure. This surgical technique involves resection of the rectum and colon, followed by colo-anal anastomosis and a protective ileostomy.
UNASSIGNED: The discussion highlights the rarity of RP in young adults and the associated risk factors. It emphasizes the importance of timely intervention in irreducible cases to prevent complications such as strangulation, ulceration, infection, and pain. Various surgical options exist, but in cases of strangulation requiring emergency surgery, the Altemeier procedure is the preferred approach due to its effectiveness and low morbidity. The decision to perform laparoscopic surgery depends on patient factors and surgeon expertise.
CONCLUSIONS: This case illustrates the successful management of a challenging and uncommon presentation of rectal prolapse, highlighting the value of surgical intervention in cases of strangulation.

BACKGROUND: Colonic lipomas are uncommon benign submucosal adipose tumors that are usually asymptomatic. In principle, large lipomas can cause symptoms that require further treatment. Here, we report a case of prolapsed giant rectal lipoma and transanal mass resection.
METHODS: A 65-year-old male developed rectal mass prolapse with bloody stool for 1 day.
METHODS: The pathological findings were rectal lipoma.
METHODS: After resection of the anal tumor, the patient postoperative symptoms quickly disappeared.
RESULTS: No recurrence of the condition was observed after 6 months of follow-up after surgery.
CONCLUSIONS: It is safe and feasible for us to perform transanal mass resection for giant rectal lipomas that protrude outside the anus.

UNASSIGNED: A giant bladder stone (BS) in the urinary tract system with a rectal prolapse complication is a rare urologic problem; it is even rarer in pediatric patients. In the case of bladder stone formation, a variety of steps result in a variety of stone compositions. This study aims to understand the rare disease course of a one-year-old patient with bladder and urethral stones and a rectal prolapse complication.
METHODS: A one-year-old boy presented with an inability to urinate since morning. It was a recurring incident for about a year but never resolved. The patients experienced irregular diarrhea and difficulty eating and drinking. Anal inspection revealed prolapse recti. The laboratory investigation found leukocytosis and anemia with normal blood urea nitrogen and creatinine. Urine tests revealed leukocyturia and hematuria. A plain radiograph of the abdomen showed a round opacity around the pelvic area. Ultrasonography of the abdomen and urinary tract revealed a giant BS and severe bilateral hydronephrosis. Thus, a cystolithotomy procedure was performed, and an additional urethral stone was found. Obtained bladder stones with a size of 30 × 21 × 15mm, with 57 % of uric acid and 33 % of calcium oxalate. A manual reduction of the prolapsed rectum was also performed during surgery. There was no recurrence of the prolapsed rectum after surgery.
UNASSIGNED: BS is very rare in the pediatric population. The development of our case\'s stone composition starts with pure uric acid, which is later enveloped by calcium oxalate due to its lack of acidic atmosphere. Rectal prolapse occurs due to increased abdominal pressure caused by straining during urination.
CONCLUSIONS: The pathogenesis of BS is multifactorial, with local and systemic factors. Early diagnosis and comprehensive history-taking are essential for BS management decisions. The management of BS depends on its size, composition, and symptoms.

UNASSIGNED: Colorectal intussusception can be quite challenging to identify, especially its malignant nature. This is a fairly rare presentation and hence, there is not much associated research or cases reported in the literature.
METHODS: We present a 69 year old male with lower abdominal pain and a significant rectal prolapse. He has a background history of heavy smoking and significant alcohol intake. The prolapse was irreducible and had papillomatous changes present on the prolapsed mucosa. A computerized tomography (CT) scan demonstrated a large rectal prolapse followed by a Magnetic Resonance Imaging (MRI) Pelvis which showed an intussusception at the S2-3 level, consistent with a carcinoma, The patient then proceeded to have a flexible sigmoidoscopy with a planned proceed to an anterior resection. Histopathology revealed sigmoid and descending colon adenocarcinoma with mucinous differentiation pT3N0. He had an unremarkable hospital stay and remained well on follow up. His case was discussed at the multidisciplinary meeting and was not for any adjuvant chemotherapy.
UNASSIGNED: Imaging can help aid early diagnosis of a colorectal intussusception. Colonoscopies can be useful too; however these can be tricky to diagnose pre-operatively. If there is a high suspicion of malignancy, routine resection is the preferred method of treatment in cases of colorectal intussusception.
CONCLUSIONS: Although not a very common presentation, diagnosis of colorectal cancer presenting as an intussusception can be dealt with imminently by considering operative measures.