Skip to main content

Advertisement

SpringerLink
Log in

Rectal Prolapse in Children: Significance and Management

  • Pediatric Gastroenterology (SR Orenstein, Section Editor)
  • Published:
Current Gastroenterology Reports Aims and scope Submit manuscript

Abstract

Rectal prolapse is a herniation of the rectum through the anus. It is rare in children. When it does occur, it is usually prior to 4 years of age and due to anatomical variants. A few conditions predispose children to rectal prolapse, the most common being constipation. Cystic fibrosis used to be commonly associated with rectal prolapse, but with the advent of cystic fibrosis newborn screening, this association is no longer as frequently seen. Many recent case reports, detailed in this chapter, describe conditions previously unknown to be associated with rectal prolapse. Management is usually supportive; however, rectal prolapse requires surgical management in certain situations. This review details the presentation of rectal prolapse, newly described clinical manifestations, and associated conditions, and up-to-date medical and surgical management.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. Siafakas C, Vottler TP. Rectal prolapse in pediatrics. Clin Pediatr. 1999;38:63–72.

    Article  CAS  Google Scholar 

  2. Freeman NV. Rectal prolapse in children. Journal of Royal Society of Medicine. 1984;77:9–12.

    Google Scholar 

  3. Laituri CA, Garey CL. 15-Year experience in the treatment of rectal prolapse in children. J Pediatr Surg. 2010;45:1607–9.

    Article  PubMed  Google Scholar 

  4. Antao V, Bradley V, et al. Management of rectal prolapse in children. Dis Colon Rectum. 2005;48:1620–5.

    Article  CAS  PubMed  Google Scholar 

  5. Sarmast MH, Askarpour S. Rectal prolapse in children: a study of 71 cases. Prz Gastroenterol. 2015;10(2):105–7.

    PubMed  PubMed Central  Google Scholar 

  6. Gourgiotis S, Baratsis S. Rectal prolapse. Int J Colorectal Disease. 2007;22:231–43.

    Article  Google Scholar 

  7. Cares K E, El-Baba M. Su1166 Rectal prolapse and its clinical characteristics in children. Gastroenterology. 2015;148(4):S-425 (abstract).

  8. Munns J, Amawi J. A large urinary bladder stone: an unusual case of rectal prolapse. Arch Dis Child. 2010;95:1026.

    Article  PubMed  Google Scholar 

  9. Lauschke H. Large urinary bladder stones associated with prolapse of the rectum in children: case report. Trop Doct. 1989;19:65–6.

    CAS  PubMed  Google Scholar 

  10. Chen CY, Wu CC. Primary non-Hodgkin’s lymphoma of rectum presenting with rectal prolapse. J Pediatr Surg. 2009;44:E1–2.

    Article  PubMed  Google Scholar 

  11. Jan IA, Saleem N. Rectal prolapse: an unusual presentation of malakoplakia in a child. J Coll Physicians Surg Pak. 2003;13:536–7.

    PubMed  Google Scholar 

  12. Monig S, Selzner MD, et al. Peutz-Jeghers syndrome in a child: prolapse of a large colonic polyp through the anus. J Clin Gastroenterol. 1997;25:703–4.

    Article  CAS  PubMed  Google Scholar 

  13. Rathi S, Pednekar K, et al. Screw-worm myiasis of prolapsed rectum. Indian Pediatr. 2014;51:53–4.

    Article  PubMed  Google Scholar 

  14. Pancharoen C, Likitnukul S. Rectal prolapse associated with cytomegalovirus pseudomembranous colitis in a child infected by human immunodeficiency virus. Southeast Asian J Trop Med Public Health. 2003;34:583–4.

    PubMed  Google Scholar 

  15. Villarreal M, Brum P. Rectal prolapse in a neonate with Shigella diarrhea. Arch Argent Pediatr. 2010;108:e17–9.

    PubMed  Google Scholar 

  16. Gangopadhyay AN, Gupta DK. Pig bite of prolapsed rectum of child. J Pediatr Surg. 2002;37:657–8.

    Article  CAS  PubMed  Google Scholar 

  17. Sengar M, Neogi S, et al. Prolapse of the rectum associated with spontaneous rupture of the distal colon and evisceration of the small intestine through the anus in an infant. J Pediatr Surg. 2008;43:2291–2.

    Article  PubMed  Google Scholar 

  18. Cares K, Poulik J, et al. Celiac disease in a child presenting with recurrent rectal prolapse. JPGN. 2014.

  19. Shah A, Parikh D, et al. Persistent rectal prolapse in children: sclerotherapy and surgical management. Pediatr Surg Int. 2005;21:270–3.

    Article  CAS  PubMed  Google Scholar 

  20. Lucarelli S, Nardo GD, et al. Rectal prolapse in a child with cow’s milk allergy. Int J Colorectal Dis. 2009;24:1239.

    Article  PubMed  Google Scholar 

  21. Huang SC, Yang YJ, et al. Rectal prolapse in a child: an unusual presentation of Clostridium difficile–associated pseudomembranous colitis. Pediatr Neonatol. 2011;52:110–2.

    Article  PubMed  Google Scholar 

  22. Zwiener RJ, Belknap WM, et al. Severe pseudomembranous enterocolitis in a child: case report and literature review. Pediatr Infect Dis J. 1989;8:876–82.

    Article  CAS  PubMed  Google Scholar 

  23. de Kerlivio CF, Willot S, et al. Rectal prolapse in a 3-year-8-month-old child. Arch Pediatr. 2008;15:1437–9.

    Article  PubMed  Google Scholar 

  24. Cares K, El-Baba M. A 9-month-old presenting with rectal prolapse. Gastroenterology. 2016;150:42–3.

    Article  PubMed  Google Scholar 

  25. Juern J, Schmeling D, et al. Transanal wading pool suction-drain injury resulting in complete evisceration of the small intestine: case report and review of the literature. J Pediatr Surg. 2000;45:E1–3.

    Article  Google Scholar 

  26. Price N, Soundappan SV, et al. Swimming pool filter-induced transrectal evisceration in children: Australian experience. MJA. 2010;192:534–6.

    PubMed  Google Scholar 

  27. http://www.poolsafely.gov/pool-spa-safety-act/read/

  28. Zhu QC, Shen RR, et al. Solitary rectal ulcer syndrome: clinical features, pathophysiology, diagnosis and treatment strategies. World J Gastroenterol. 2014;20:738–44.

    Article  PubMed  PubMed Central  Google Scholar 

  29. Dehghani SM, Malekpour A, et al. Solitary rectal ulcer syndrome in children: a literature review. World Journal of Gastroentorology. 2012;18:6541–5.

    Article  CAS  Google Scholar 

  30. Uganci N, Kalyoncu D, et al. Solitary rectal ulcer syndrome in children: a report of six cases. Gut Liver. 2013;7:752–5.

    Article  Google Scholar 

  31. Keshtgar AS. Solitary rectal ulcer syndrome in children. Eur J Gastroenterol Hepatol. 2008;20:89–92.

    Article  PubMed  Google Scholar 

  32. Stern RC, Izant RJ, et al. Treatment and prognosis of rectal prolapse in cystic fibrosis. Gastroenterology. 1982;82(4):707–10.

    CAS  PubMed  Google Scholar 

  33. Zempsky WT, Rosenstein BJ. The cause of rectal prolapse in children. Am J Dis Child. 1988;142(3):338–9.

    CAS  PubMed  Google Scholar 

  34. El-Chammas KI, Rumman N, et al. Rectal prolapse and cystic fibrosis. JPGN. 2015;60:110–2. Study reassessing the risk of cystic fibrosis after implementation of newborn screening.

    PubMed  Google Scholar 

  35. Flum AS, Golladay ES, et al. Recurrent rectal prolapse following primary surgical treatment. Pediatr Surg Int. 2010;26:427–31.

    Article  PubMed  PubMed Central  Google Scholar 

  36. Sun C, Hull T. Risk factors and clinical characteristics of rectal prolapse in young patients. J Visc Surg. 2014;151:425–429.7. Current review of risk factors in patients with recurrent rectal prolapse requiring surgical management.

    Article  CAS  PubMed  Google Scholar 

  37. Marceau C, Parc Y, et al. Complete rectal prolapse in young patients: psychiatric disease a risk factor of poor outcome. Colorectal Dis. 2005;7:360–5.

    Article  CAS  PubMed  Google Scholar 

  38. Leroi AM, Lalaude O, et al. Prolonged stationary colonic motility recording in seven patients with severe constipation secondary to antidepressants. Neurogastroenterol Mot. 2000;12:149–54.

    Article  CAS  Google Scholar 

  39. Van Heest R, Jones S, et al. Rectal prolapse in autistic children. J Pediatr Surg. 2004;39:643–4.

    Article  PubMed  Google Scholar 

  40. Hill SR, Ehrlich PF, et al. Rectal prolapse in older children associated with behavioral and psychiatric disorders. Pediatr Surg Int. 2015;31:719–24.

    Article  PubMed  Google Scholar 

  41. Zganjer M, Cizmic A. Treatment of rectal prolapse in children with cow milk injection sclerotherapy: 30-year experience. World J Gastroenterol. 2008;14:737–40.

    Article  PubMed  PubMed Central  Google Scholar 

  42. Wu JS. In brief. Curr Probl Surg. 2009;46:598–600.

    Article  Google Scholar 

  43. Brown AJ, Anderson JH. Surgery for occult rectal prolapse. Colorectal Dis. 2004.

  44. Hight DW, Hertzler JH, et al. Linear cauterization for the treatment of rectal prolapse in infants and children. Surg Gynecol Obstet. 1982;154:400–2.

    CAS  PubMed  Google Scholar 

  45. Madiba TE, Baig MK, et al. Surgical management of rectal prolapse. Arch Surg. 2005;140:63–73.

    Article  PubMed  Google Scholar 

  46. Schepens M, Verhelst AA. Reappraisal of Ekehorn’s rectopexy in the management of rectal prolapse in children. J Pediatr Surg. 1993;28:1494–7.

    Article  CAS  PubMed  Google Scholar 

  47. Lee JI, Vogel AM. Sequential linear stapling technique for perineal resection of intractable pediatric rectal prolapse. Am Surg. 2006;72:1212–5.

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Pediatric Gastroenterology, Children’s Hospital of Michigan, 3901 Beaubien Blvd, Detroit, MI, 48201, USA

    Kristen Cares & Mohammad El-Baba

Authors
  1. Kristen Cares
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Mohammad El-Baba
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Kristen Cares.

Ethics declarations

Conflict of Interest

The authors declare that they have no conflicts of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

Additional information

This article is part of the Topical Collection on Pediatric Gastroenterology

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Cares, K., El-Baba, M. Rectal Prolapse in Children: Significance and Management. Curr Gastroenterol Rep 18, 22 (2016). https://doi.org/10.1007/s11894-016-0496-y

Download citation

  • Published:

  • DOI: https://doi.org/10.1007/s11894-016-0496-y

Keywords

Search

Navigation