The management of irreducible rectal prolapse is controversial. Surgeons may attempt conservative management by application of sugar. When surgery becomes inevitable the choice of procedure varies. We reviewed eight cases and noted the clinical findings and the results of conservative and surgical management. In four cases sugar was applied first, and failed. Emergency surgery always gave good outcomes. The procedures included simple reduction, rectopexy, laparotomy with resection, Delorme's repair, and perineal resection. Our experience and review of the literature indicate that surgery should be performed early in irreducible prolapse. Perineal resection may be the most suitable emergency procedure.
A patient who underwent emergency laparotomy for rectal prolapse developed repeated abdominal wound dehiscence and subsequently an enteric fistula. The management of abdominal wound dehiscence is discussed, specifically with regards to the Bogota bag. Use of Bogota bag has been reported worldwide but this may be the first report here.