Rectal Prolapse

Question 1

def

Answer 1

abnormal protrusion of rectal mucosa or full thickness rectal wall through the anus

Question 2

aetiology

Answer 2

1 incomplete prolapse
-prolapse involving only the mucosa
-in children + adults
-associated with straining + constipation
2 complete prolapse
-prolapse involving the entire rectal wall
-in adults
-associated with weak pelvic + anal musculature, straining + constipation

Question 3

what neurological condition is complete prolapse associated with

Answer 3

MS

Question 4

epi

Answer 4

peaks in children (male+female) and in the elderly (female>male)

Question 5

history

Answer 5

1 protruding anal mass
2 constipation
3 faecal incontinence
4 bleeding/mucus in stool

Question 6

when would rectal prolapse be an emergency

Answer 6

irreducible or strangulated prolapse

Question 7

examination

Answer 7

1 prolapse observed on straining

2 reduced anal sphincter tone

Question 8

investigations

Answer 8

imaging

• proctosigmoidoscopy
• defaecating proctogram
• barium enema

Question 9

what test would be performed in children with rectal prolapse

Answer 9

sweat chloride test

10% will have CF