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Background
The incidence of prolapse of stoma is about 2-26%. 1 Prolonged exposure of the prolapsed stoma can lead to mucosal ulcerations, bleeding and, rarely, incarceration. 2
Manual reduction of a prolapsed stoma, though attempted initially, may be unsuccessful owing to the prolapse becoming oedematous and difficult to manipulate. An irreducible prolapse might necessitate surgical correction which is not without risks and associated morbidities especially in the elderly population. A successful reduction can eliminate the need for emergency surgery and can allow planning for elective surgery at a later stage.
Case presentation
A frail 94-year-old patient who was undergoing palliative radiotherapy for an irresectable rectal tumour presented to us with a prolapse of his defunctioning ileostomy. Upon examination, there was approximately 30 cm of prolapsed small bowel which was very oedematous and congestion of the mucosa was found. He complained of gripping intermittent abdominal pain but denied any vomiting and nausea.
Treatment
Gentle manual reduction of the prolapse was attempted but failed because of gross oedema. Figure 1 shows the prolapsed bowel. One kilogram of granulated table sugar was then applied to the stoma for 15 min ( figure 2 ) and...