Altemeier perineal rectosigmoidectomy with indocyanine green fluorescence imaging for a female adolescent with complete rectal prolapse: A case report

Figure 1 Colonoscopy examination showed redness and erosion on the rectal mucosa.

Figure 2 Computed tomography scans of the abdomen and pelvis. A: Diffuse rectal wall thickening (arrowheads) was seen; B: The peritoneal reflection lay below the lower sacrum, accompanied by a thickened rectal wall.

Figure 3 Preoperative appearance of the rectal prolapse. A complete rectal prolapse, with a 10 cm-long reddish section of the rectum, is seen.

Figure 4 Intraoperative indocyanine green fluorescence imaging. A: The proximal rectum (arrowhead) was pulled out through the anus [before indocyanine green (ICG) administration]; B: ICG fluorescence imaging of the proximal rectum (arrowhead), showing a visible blood supply to the rectum. The rectum was transected on the line with good blood flow (arrow); C: Completion of the Altemeier operation.