RECTAL PROLAPSE - modified Thiersch’s procedure
Rectal prolapse in children is usually caused by longstanding diarrhea and/or intestinal parasites often combined with malnutrition.
The prolapse can easily be reduced by continuous and patient compression of the edematous prolapse the same as when reducing a paraphimosis or longstanding intussusception.
Strapping the buttocks with adhesive tape will keep the rectum reduced and can be used as the sole treatment.
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That is however a messy and time consuming option. Far better is to maintain the reduction with a perianal cerclage of heavy chromic catgut - a modified Thiersch procedure (in the original version stainless steel wire was used). Applying several circles of the heavy chromic catgut creates a fibrotic ring which will help in preventing recurrence.
Two small incisions strictly anteriorely and posteriorely are made in the skin through which several circles of heavy chromic catgut is placed around the anus with a large curved needle. The suture is tightened with the assistant’slittle finger inserted in the anus. The incisions are left open.
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