Many techniques are described to manage recurrent
rectal prolapse in children, including repeated Thiersch stitch,
phenol injections, Delorme and Altemeier procedures, and rectopexy. We describe a case of successful treatment of
rectal prolapse by placing three Thiersch
sutures circumferentially along the anal canal--a simple and novel modification of a well-known procedure. An 8-year-old boy with full-thickness
rectal prolapse was treated with laxatives to no avail. He was subsequently treated with
phenol-in-
almond-oil injection and insertion of a 1/0PDS Thiersch
suture. The effects were temporary with recurrence 3 months later. A further
phenol-in-
almond-oil injection was given and a 1/0PDS Thiersch
suture placed, and the patient was discharged on laxatives. Recurrence occurred again at 3 months. This was treated with three circumferential Thiersch
sutures along the anal canal--one
Prolene 2/0 and two 1/0PDS. There has been no recurrence at follow-up. Placement of three sequential Thiersch
sutures along the rectum is effective in treating recurrent
rectal prolapse and a good alternative to major rectopexy.