As a nurse, Corrimal mum Kelly Bolton has seen many things, but she was still shocked when she found her little boy in the bathroom with about five centimetres of his rectum hanging out.
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After three-year-old Samuel was rushed to Wollongong Hospital by ambulance, Mrs Bolton was even more dismayed that he received only "Band-Aid treatment" before being sent home with the advice to return if it happened again.
It did happen again - less than 10 hours later - and Mrs Bolton wrapped up her distressed child and took him back to the ED, where she faced a five-hour wait before again being told to go home.
She is angry that the lack of a paediatric surgeon in the region means she has no option but to now take Samuel to Sydney for surgery to fix the problem, which has happened several times since the trips to the ED.
"A prolapsed rectum happens when part of the rectum turns itself inside out like a sausage and hangs out," Mrs Bolton said.
"Because it had gone back in by the time Samuel was seen by the doctors in the emergency department, they told us there was nothing they could do and it would need surgical intervention to stop it happening again.
"Unfortunately, because of the lack of a paediatric surgeon here, the stitching that's needed to hold it in place cannot be carried out here.
"This region needs a paediatric surgeon - our children are our most precious assets. Why should they be taken away from familiar surroundings and cast off to Sydney when they should be fixed here?"
A national shortage of paediatric surgeons means Mrs Bolton and her husband, Brent, remain on tenterhooks while they try to make the necessary arrangements.
They've been told that many Sydney-based paediatric surgeons are still on summer holidays, but they are hoping to get an appointment this week, and surgery soon after.
"It's happened numerous times since Saturday but I refuse to go back to the ED and sit for hours just to be told to go home and wait," Mrs Bolton said.
"When it happens, I give Samuel a wet pack and lay him on the couch and wait 10 to 15 minutes and check whether it's gone back in.
"The problem is that if it's out for longer than 15 minutes, he can get oedema where it will swell and won't be able to go back in - which can cause it to go necrotic and die."
Mrs Bolton said prolapse was more common in the elderly, or women with children who could suffer from a prolapsed uterus.
She has been told by specialists that there is usually an underlying issue causing rectal prolapse in young children, and genetic and other testing will be required.
"When Samuel called me into the bathroom on Saturday, I couldn't believe it," she said.
"He was very distressed and crying and was in a lot of pain. Because it keeps happening, he is very scared and even asked me: 'Mummy, am I going to die and go to heaven'.
"I'm a nurse but I'm speaking out purely as a mother because parents wouldn't be aware that we don't have a paediatric surgeon here to help their children."
In an article in Monday's Mercury, it was revealed that efforts to attract a paediatric surgeon to the region have been in vain since the last one left Wollongong Hospital 18 months ago.
Illawarra Shoalhaven Local Health District acting director clinical operations Suzanne Harris said the recruitment had been a challenge due to the national shortage of such specialists.
However, she said a review showed that the majority of paediatric surgical cases would have needed to be transferred to specialist Sydney children's hospitals regardless of the availability of a paediatric surgeon.
