What are the possible complications of pediatric rectal prolapse?

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

Complications of rectal prolapse include:

  • Incarceration - Entrapment of the prolapsed intestine making it irreducible; it may lead to strangulation of the prolapsed segment

  • Strangulation and gangrene - When the prolapse is not reduced in a timely fashion, the resulting edema further precludes its reduction; the impaired blood flow to the mucosa endangers the viability of the prolapsed segment, mandating emergency resection

  • Ulceration and hemorrhage - Trauma over the exposed mucosa produces ulceration, bleeding, and mucous discharge; occurs in about 12% of patients; treatment involves correction of straining and defecation habits

  • Prolapse rupture - Excoriation of the mucosa can perforate the prolapsed intestine; urgent surgery is indicated

  • Incontinence - Observation for 6-12 months is appropriate because it is likely to resolve spontaneously

  • Cancer risk - No clear correlation between colorectal tumors and rectal prolapse has been established; however, a study in adults demonstrated a 4.2-fold increase in the relative risk for rectal cancer in patients with rectal prolapse [28]


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