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Paper Title: Neglected huge rectal prolapse in immunocompromise: the place for Thiersch.

Authors: Igwe P.O, Dodiyi-Manuel A, Kalu G.A.

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Rectal prolapse is not an uncommon condition in an immunocompromised individual. It occurs when all or part of the rectum protrudes
through the anal canal. It is often a distressing condition to patients and relatives. The place of Thiersch wiring is to be emphasized as well
as review of literature.

This is to report a case of huge rectal prolapse in an immunocompromised individual and emphasize the place of Thiersch wiring.
Case Report:

A 49 year old business man presented with complaints of anal protrusion of 3 days duration. It has been recurring especially during
defaecation and reducible spontaneously for the past 10 years until 3 days prior to presentation when it became irreducible. He had no
bleeding per rectum. It was painless, with nocturia, frequency and polyuria . There was a prior history of lifting of a heavy log of wood.
There were unsuccessful attempts at reduction in a peripheral center.
Examination revealed a middle aged man with stable vital signs but with a huge mass in the rectum. An emergency reduction and thiersch
procedure was done under regional anaestheisia. Procedure was well tolerated. His outpatient follow up has been uneventful.

Thiersch wiring repair has a place in immunocompromised especially where minimal procedure is best due to patients survival and
surgeons safety.

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