Recurrent prolapse of the rectum in old patients is treated by:
Rectal prolapse- Rectal Prolapse is of two types* Mucosal (mainly in children)* Full thickness (mainly in adults) Causes of rectal prolapse common causes- Protein Energy Malnutrition- Worm infestation- Diarrhea Rare causes:- Sacral agenesis- Meningomyelocele Management- Depends on cause- Conservative Management for common causes- If patient is not responding - LOKHA - MUMMARY RECTOPEXY- For rare causes - THIERSCH ANAL WIRING - For Adults - Rectopexy Abdominal approach & Rectopexy Perineal approachRectopexy Abdominal Approach- Decreased recurrence rate- Associated with high morbidity- Preferred in young patients- Types of rectopexy* W - Well's* A - Abdominal* R - Ripstein- RESECTION RECTOPEXY* Goldman - Fryberg Rectopexy Perineal Approach- Increased recurrence rate- Associated with low morbidity- For old & frail patients- Types of rectopexy* P - Perineal* A - Altmaier* D - Delorme- THIERSCH ANAL WIRING
Thiersch wiring
Digital reposition
Excision
Ripstein's operation
GIT