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Review
, 30 (1), 16-21

Evaluation, Diagnosis, and Medical Management of Rectal Prolapse

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Review

Evaluation, Diagnosis, and Medical Management of Rectal Prolapse

Jamie A Cannon. Clin Colon Rectal Surg.

Abstract

Full-thickness rectal prolapse, or procidentia, is the passage of the full-thickness wall of the rectum beyond the anal sphincters. This condition results in pain and fecal incontinence which greatly impairs the quality of life of those afflicted. It is associated with several anatomic abnormalities, including decreased anal sphincter tone, levator muscle diastasis, and a deep anterior cul-de-sac. The diagnosis of rectal prolapse is made based on physical examination, although several other modalities are used to provide additional information about the patients' condition. While medical management of rectal prolapse can be effective in some cases, the mainstay of management of rectal prolapse is surgical correction.

Keywords: procidentia; rectal prolapse.

Figures

Fig. 1
Fig. 1
Rectal prolapse.
Fig. 2
Fig. 2
Rectal prolapse.
Fig. 3
Fig. 3
Large edematous rectal prolapse, which is more prone to incarceration.
Fig. 4
Fig. 4
Incarcerated prolapsed internal hemorrhoids.
Fig. 5
Fig. 5
Early rectal prolapse.
Fig. 6
Fig. 6
MR defecography of rectal prolapse, credit to Thapar et al. Normal position at rest (A). During defecation (B–E), there is a rectorectal intussusception which progressively descends and eventually causes a rectal prolapse with mucosal outpouching through the anal verge (open arrow in E).
Fig. 7
Fig. 7
MR defecography of rectal prolapse (Figure courtesy of Mizell and Dr. Roopa Ram, UAMS).

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