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Abstract
Rectal prolapse is the condition in which part or all of the rectum protrudes through the anal orifice. This is one of the most common lesions of the rectum infants and children. It occurs most commonly under the age of 4 years with highest incidence in the first year with both sexes affected equally. Prolapse becomes uncommon in late childhood and early adulthood.
It is related to several anatomical considerations such as vertical course of the rectum, increased mobility of the sigmoid colon, lack of support of levator ani muscle, loose attachment of the rectal mucosa to the underlying muscularis and absence of Houston’s valves. It is also predisposed to by increased intra-abdominal pressure, diarrheal disease, parasitic and neoplastic diseases of the rectum, malnutrition, cystic fibrosis and pelvic floor weakness.
Various complications can be encountered as superficial infection and ulceration of the exposed mucosa, intermittent bleeding with subsequent anemia. In long standing cases proctitis may develop in addition to weakness of the external sphincter that may compromise the continence mechanism.
It is a stressful condition to the parents who usually see a dark, reddened mass emerging from the anal verge with excess mucus and/or traces of blood when the child defecates. It is reduced spontaneously at the end of the act; at other times it is required to be replaced digitally.