When is surgery indicated in the treatment of pediatric rectal prolapse?

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

Surgery is infrequently required for rectal prolapse. However, if the prolapse persists after an adequate trial of medical therapy, surgical intervention may be required. Age, duration of conservative management, and frequency of recurrence should be taken into consideration. Pain, excoriations, and rectal bleeding are considered indications for surgical treatment.

When the prolapse cannot be reduced or if necrosis is already present, emergency surgical resection is indicated. [46] If a recurrent prolapsed rectum is successfully reduced in the emergency department, surgery is scheduled within the next 2 weeks to allow the edema to subside before the procedure.

The main purpose of surgical treatment for rectal prolapse is correction of the prolapsed rectum and recovery and prevention of the associated defecation dysfunction. Therefore, when selecting surgical methods, the surgeon should understand the exact causative factors and anatomical variations. [27]

The only absolute contraindication for surgery is poor general condition that precludes a major operation.


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