What is the focus of clinical history to evaluate pediatric rectal prolapse?

Updated: Nov 12, 2018
  • Author: Jaime Shalkow, MD, FACS; Chief Editor: Carmen Cuffari, MD  more...
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Answer

History of neonatal stooling problems or cases of cystic fibrosis in family members should be sought. The clinician should ask about excessive straining due to constipation or diarrhea (most common), prolonged toilet sitting with hips and knees flexed, and operative correction of imperforate anus. Inquire about history of the following:

  • Ehlers-Danlos syndrome

  • Hirschsprung disease

  • Congenital megacolon

  • Polyps

  • Pneumonia

  • Pertussis

  • Malnutrition/anorexia

  • Myelomeningocele

  • Parasitic infection

  • Rectal neoplasm and rectal duplication cyst have also been reported [25, 26]

Patients with rectal prolapse frequently have an associated dysfunction, either fecal incontinence (50%) or constipation (15-65%). Excessive pushing during defecation induces mucosal injury of the anterior rectal wall, which may lead to a solitary rectal ulcer. [27]


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