What Causes Rectal Prolapse?

Discussion Rectal prolapse is defined as a herniation of the rectum through the anal verge. In children it is also usually mucosal prolapse and not full thickness. Partial or mucosal prolapse usually is seen as radial folds occurring 1 – 2.5 cm from the anal verge. Full thickness will protrude more than 5 cm. It affects genders equally and occurs most commonly in children under age 4. This is due to vertical course and low position of the anus, looser supporting tissues and less muscular support. These children are more likely to have prolapse but are less likely to have it recur. After age 4 the rectum takes the adult shape and more posterior position which lowers its occurrence. However, in older children it is more likely to recur. Presentation is usually during defecation and is usually painless but patients may feel the mass or have a feeling of incomplete defecation or tenesmus. The prolapse looks like a beefy red mass. As prolapse usually resolves, having the patient perform a Valsalva maneuver or squat may reproduce the prolapse. Prolapses that do not resolve may become edematous, with bleeding and ulceration sometimes occurring. This also makes reduction more difficult. Rectal prolapse can be, but rarely is incarcerated. Treatment includes spontaneous resolution as noted. Digital replacement is often the next step and may require take several minutes to allow the tissues to become less edematous and remain in place. Some have used sugar to reduce the edema simi...
Source: PediatricEducation.org - Category: Pediatrics Authors: Tags: Uncategorized Source Type: news