Rectal prolapse in children
- Leonel A Rodriguez, MD, MS
Leonel A Rodriguez, MD, MS
- Assistant Professor of Pediatrics
- Harvard Medical School
- Director, Colorectal Program
- Co-Director, Colorectal and Pelvic Malformation Center, Assistant in Pediatrics
- 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
This topic will discuss the clinical manifestations, diagnosis, and management of rectal prolapse in children.
Rectal prolapse in adults is discussed separately. (See "Overview of rectal procidentia (rectal prolapse)" and "Surgical approach to rectal procidentia (rectal prolapse)".)
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. Self-limited conditions are more common between infancy and four years of age, with the highest incidence in the first year of life [1,5]. Those presenting beyond 4 years of age usually have a chronic predisposing condition (see below). Observational reports suggest that during childhood, rectal prolapse occurs in higher frequency in boys [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:To continue reading this article, you must log in with your personal, hospital, or group practice subscription. For more information on subscription options, click below on the option that best describes you:
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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