title: Strangulated ileal trans-coloanal-anastomotic hernia: a complication of Altemeier's procedure previously never reported.
abstract: A postoperative complication after Altemeier operation, so far never reported, is described in a 42 years old mentally disabled patient with external full thickness rectal prolapse who usually had prolonged straining at defecation. After 6 d from perineal rectosigmoidectomy, the patient, was discharged free of complications. Four days later he was readmitted in emergency for strangulated perineal trans-anastomotic ileal hernia that occurred at home during efforts to defecate. The clinical feature required an emergency operation for repositioning the ileal loops into the abdomen, resection of the necrotic ileum, and end colostomy. The outcome of the second operation was free of complication and the patient was discharged on the 6(th) postoperative day. In conclusion, after Altemeier operation prolonged straining at defecation should be carefully avoided.
authors: Department of Emergency and Organ Transplantation, University "Aldo Moro" of Bari, 70124 Bari, Italy.
authors: Maria
authors: M
authors: Di Lena
authors: Emanuele
authors: E
authors: Angarano
authors: Ivana
authors: I
authors: Giannini
authors: Altomarino
authors: A
authors: Guglielmi
authors: Donato Francesco
authors: DF
authors: Altomare
mesh_terms: D000328:Adult; D000714:Anastomosis, Surgical; D003106:Colon / Q000601:surgery*; D003125:Colostomy; D003672:Defecation; D013505:Digestive System Surgical Procedures / Q000009:adverse effects*; D046449:Hernia, Abdominal / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology / Q000601:surgery; D059685:Herniorrhaphy; D006801:Humans; D007082:Ileum / Q000601:surgery*; D008297:Male; D020127:Recovery of Function; D012005:Rectal Prolapse / Q000503:physiopathology / Q000601:surgery*; D012007:Rectum / Q000601:surgery*; D012086:Reoperation; D013997:Time Factors; D016896:Treatment Outcome
keywords: Altemeier’s procedure; Complication; Hernia; Perineal rectosigmoidectomy; Rectal prolapsed