Concurrent total abdominal colectomy and ileorectal anastomosis with transvaginal posterior colporrhaphy for constipation

Excerpt

Constipation, one of the most commonly encountered gastrointestinal disorders, is associated with impaired quality of life and a large economic burden. Studies estimate the prevalence of constipation in the general population to be 12–19% and up to 30–40% among people >65 years of age [1, 2]. The high rate of recurrence of constipation in the elderly can result in fecal impaction, stercoral ulcers, and volvulus [3]. Constipation can be categorized as slow-transit constipation, normal-transit constipation, or obstructed defecation, with diagnoses occurring separately or in combination [4]. Patients with severe slow-transit constipation have an increased risk of pelvic organ prolapse (POP) due to chronic straining. Prior to surgical correction of the prolapse, it is necessary to address the underlying risk factors, such as slow-transit constipation, often with a separate subtotal or total colectomy [4‐6]. We report a case of a patient with a longstanding history of slow-transit constipation and rectocele, with impressive images to further illustrate the lasting effects of constipation on the gastrointestinal system. Due to the duration and severity of the symptoms despite medical management, the patient underwent a combined total abdominal colectomy with ileorectal anastomosis and a transvaginal posterior colporrhaphy. …