Perineal sigmoidectomy for sigmoid procidentia: report of a case.

Although rectal procidentia is not an uncommon disease, presentation of more proximal segments of the large bowel through the anus is extremely rare. We report a male patient with an acute sigmoid prolapse secondary to a large villous adenoma acting as the lead point. Since the prolapsed segment was irreducible and exhibited signs of vascular compromise, an intraoperative colonoscopy and perineal sigmoidectomy with a primary anastomosis was carried out. Postoperatively, the patient did well and was discharged 5 days after his operation. Recognition of the difference between sigmoid and rectal procidentia should influence the surgeon's choice of operation, along with the viability of the prolapsed bowel and overall condition of the patient.