One Operation for Double Pathology

Abstract

The patient complained of diarrhea and mucous discharge for 13 years. There had been intermittent rectal bleeding. Prolapse of the rectum had been noted for a period of 12 months. There had been recent weight loss and general weakness. On digital rectal examination, a soft polyp encircling the rectum was easily palpable at the 7cm level. Complete rectal prolapse was present on straining. There was laxity of the anal sphincter. Sigmoidoscopy revealed an extensive rectal polyp with a combination of flat and polypoid contours. The upper limit of the polyp was 20cm from the anal verge. There were no macroscopic features to suggest malignancy. There were abnormalities of biochemistry on blood examination: Na, 125mmol/L (N-134–143); K, 3.8mmol/L (N-3.5–5.0); Urea, 28.9mmol/L (N-2.0–7.0); and creatinine, 0.21mmol/L (N-0.05–0.11).