Rectal prolapse in children
- Rana Kronfol, MD
Rana Kronfol, MD
- Clinical Associate Faculty
- Texas Technical University Health Sciences Center, El Paso, Texas
- Section Editors
- Craig Jensen, MD
Craig Jensen, MD
- Section Editor — Pediatric Gastroenterology
- Associate Professor
- Baylor College of Medicine
- Jonathan I Singer, MD
Jonathan I Singer, MD
- Section Editor — Pediatric Surgical Emergencies
- Professor of Emergency Medicine and Pediatrics
- Wright State University Boonshoft School of Medicine
- Deputy Editor
- James F Wiley, II, MD, MPH
James F Wiley, II, MD, MPH
- Senior Deputy Editor — UpToDate
- Deputy Editor — Adult and Pediatric Emergency Medicine
- Deputy Editor — Primary Care Sports Medicine (Adolescents and Adults)
- Clinical Professor of Pediatrics and Emergency Medicine/Traumatology
- University of Connecticut School of Medicine
Rectal prolapse refers to the extrusion of some or all of the rectal mucosa through the external anal sphincter (figure 1) [1-4]. Rectal prolapse seldom occurs in children who do not have an underlying predisposing condition and usually occurs between infancy and four years of age, with the highest incidence in the first year of life [1,5]. During childhood, rectal prolapse occurs with equal frequency in boys and girls [1,6,7].
There are two types of rectal prolapse . Type I, also called false procidentia, partial, or mucosal prolapse, involves protrusion of the mucosa only and usually is less than 2 cm long. Partial rectal prolapse produces radial folds at the junction with the anal skin (figure 1).
Type II, also known as true procidentia, or complete prolapse, involves full thickness extrusion of the rectal wall and is characterized by concentric folds in the prolapsed mucosa (picture 1). This group is subdivided into three subsets according to the degree of the prolapse:
●First degree prolapse includes the mucocutaneous junction. The length of the protrusion from the anal verge usually is greater than 5 cm.
●Second degree prolapse occurs without involvement of the mucocutaneous junction. The length of the protrusion from the anal verge usually is between 2 and 5 cm.
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- PREDISPOSING CONDITIONS
- Intraabdominal pressure
- Diarrheal disease
- Cystic fibrosis
- Pelvic floor weakness
- Other factors
- CLINICAL MANIFESTATIONS
- DIFFERENTIAL DIAGNOSIS
- Manual reduction
- Surgical reduction
- INFORMATION FOR PATIENTS