Rectal Prolapse



  • 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


  • Cause unclear and multifactorial:
    • Chronic constipation/excessive straining
    • Laxity of sphincter:
      • Pelvic floor trauma/weakness; childbearing
      • Neurologic disease
  • More common in women, peak in seventh 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

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