Rectal Prolapse

Basics

Description

  • Full-thickness evagination of the rectal wall outside the anal opening
  • 3 types of rectal prolapse:
    • Full-thickness prolapse:
      • Protrusion of the rectal wall through the anal canal; the most common
    • Partial thickness or mucosal prolapse:
      • Only mucosal layer protrudes through anus
    • Occult (internal) prolapse or rectal intussusception:
      • Rectal wall prolapse without protrusion through the anus
      • May be difficult to diagnose

Etiology

  • Cause unclear and multifactorial:
    • Chronic constipation/excessive straining
    • Can occur after strenuous activity
    • Laxity of sphincter:
      • Pelvic floor trauma/weakness; childbearing
      • Neurologic disease
  • More common in women, incidence increases with each decade of life until 7th decade

Pediatric Considerations

  • Very rare after age 4 yr
  • True rectal prolapse unusual in children; more likely partial or intussusception
  • Consider chronic diarrhea, parasites, cystic fibrosis (CF), malnutrition as contributing causes

There's more to see -- the rest of this topic is available only to subscribers.