Paper Title: Neglected huge rectal prolapse in immunocompromise: the place for Thiersch.
Authors: Igwe P.O, Dodiyi-Manuel A, Kalu G.A.
Background: 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. Aim: 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. Conclusion: Thiersch wiring repair has a place in immunocompromised especially where minimal procedure is best due to patients survival and surgeons safety.