Delorme's procedure for rectal prolapse in a child refractory to conservative treatment and rectal suspension

Excerpt

Rectal prolapse in children is most commonly seen up to 3 years of age. Most respond to conservative treatment. However, we report a patient, a 1-year-old baby boy with Menke's kinky hair syndrome, who had profound hypotonia, developmental delay, long-standing constipation and large complete rectal prolapse. He failed to respond to conservative management, Thiersch stitch and posterior sagittal retro-sacral fixation. Complete prolapse recurred within 24 h of surgery, as he continued to strain. We then performed the procedure described by Delorme, which is stripping of the mucosa of the prolapsed bowel and plication of the muscle. To our knowledge, this procedure is not commonly performed in children; in our case, it had an excellent result. …