- Rectal prolapse
Name = Rectal prolapse
|www.images/google/pinksock.com Caption =
DiseasesDB = 11189
ICD10 = ICD10|K|62|3|k|55
ICD9 = ICD9|569.1
OMIM = 176780
eMedicineSubj = med
eMedicineTopic = 3533
MeshID = D012005
Rectal prolapse normally describes a medical condition wherein the walls of the
rectumprotrude through the anusand hence become visible outside the body.
There are three chief conditions which come under the title "rectal prolapse:
*"Full-thickness rectal prolapse" describes the entire rectum protruding through the anus
*"Mucosal prolapse" describes only the rectal mucosa (not the entire wall) prolapsing
Internal intussusception" wherein the rectum collapses but does not exit the anus
Rectal prolapse is caused by the weakening of the ligaments and muscles that hold the rectum in place. In most people, the anal sphincter is weak. Rectal prolapse is often associated with the following conditions: advanced age, long term constipation, long term diarrhea, long term straining during defecation, pregnancy and stresses of childbirth, previous surgery, cystic fibrosis, COPD, and sphincter paralysis.
The condition of Rectal prolapse, a type of rectal rupture, undergoes progression: beginning with prolapsation during bowel movements, through
Valsalvamovements ( sneezingand so forth), then through daily activities such as walking until finally it may become chronic and ceases to retract.
Partial prolapse may be treated by a diet high in fiber.Fact|date=August 2008
Pharmaceutically, the condition may only be treated secondarily (by treating deficate) so as to avoid further straining.
The alternative is surgery. It may be divided into two forms of procedure: abdominal surgery and perineal surgery.
*Abdominal surgery - for younger patients, but is more dangerous
*Perineal surgery - often performed on older patients and is less dangerous
**Delorme mucosal sleeve resection
**Altemeier perineal rectosigmoidectomy
*Children are treated with linear cauterization
Recently, robotic-assisted surgery has been introduced as a treatment option.cite journal |author=Heemskerk J, de Hoog DE, van Gemert WG, Baeten CG, Greve JW, Bouvy ND |title=Robot-assisted vs. conventional laparoscopic rectopexy for rectal prolapse: a comparative study on costs and time |journal=Dis. Colon Rectum |volume=50 |issue=11 |pages=1825–30 |year=2007 |month=November |pmid=17690936 |pmc=2071956 |doi=10.1007/s10350-007-9017-2 |url=http://dx.doi.org/10.1007/s10350-007-9017-2]
Because most sufferers are elderly, the condition is generally under-reported.
The condition can also occur in children.cite journal |author=Saleem MM, Al-Momani H |title=Acute scrotum as a complication of Thiersch operation for rectal prolapse in a child |journal=BMC Surg |volume=6 |issue= |pages=19 |year=2006 |pmid=17194301 |pmc=1785387 |doi=10.1186/1471-2482-6-19 |url=http://www.biomedcentral.com/1471-2482/6/19]
* [http://www.pelvicfloordigest.org/2005/prolapse_coloproctology.html Selected abstracts from recent medical literature on Rectal Prolapse]
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