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Perianal disease
Published in Alexander Trevatt, Richard Boulton, Daren Francis, Nishanthan Mahesan, Take Charge! General Surgery and Urology, 2020
Rectal prolapse is a protrusion of the rectum through the anus. This can be full thickness, involving all layers of the wall of the rectum, or mucosal, involving the mucosal layer alone. It is most common in elderly women. Risk factors include connective tissues disorder such as Marfan and Ehlers–Danlos, history of anorexia nervosa, constipation and straining, high BMI and high-birth-weight babies delivered vaginally.
Minor anal pathology: Rectal prolapse, perianal abscesses, hemorrhoids, anal fissures, and pilonidal disease
Published in Alejandra Vilanova-Sánchez, Marc A. Levitt, Pediatric Colorectal and Pelvic Reconstructive Surgery, 2020
Caitlin A. Smith, Alessandra C. Gasior, Devin R. Halleran
Chronic constipation is the main cause of rectal prolapse in this age group. If constipation is determined to be the underlying etiology, conservative management with stool softeners is usually all that is needed for treatment. Other causes of rectal prolapse included in the differential diagnosis include ileocolic intussusception [3], chronic diarrhea conditions that increase bowel motility such as Salmonella, Shigella, and Escherichia coli [1] and congenital conditions such as cystic fibrosis, myelomeningocele, spina bifida, and Hirschsprung disease [4]. In a review of 54 pediatric patients with rectal prolapse, chronic constipation was the underlying cause in 28%, followed by chronic diarrheal illness in 20%, cystic fibrosis in 11%, and neurologic or anatomic cause in 24% [5]. Other more rare causes of rectal prolapse in children include prolapsing rectal polyp or duplication cyst and rectal hemorrhoids [6,7].
The lower gastrointestinal tract, common conditions, and recommended treatments
Published in Simon R. Knowles, Laurie Keefer, Antonina A. Mikocka-Walus, Psychogastroenterology for Adults, 2019
Rectal prolapse is the protrusion of the rectal wall through the anal canal (Figure 3.3). This may represent a mucosal prolapse (protrusion of only the inner layer of the rectum) or a full-thickness prolapse (protrusion of all layers of the rectum). It is generally due to weakness or deficiency of the muscles of the pelvic floor. Patients with rectal prolapse generally describe an anal lump or bulge during strain or attempted defaecation. The prolapse may either resolve spontaneously or require manual reduction. Rectal prolapse can also cause bleeding, as a result of repeated mechanical trauma, and can contribute to continence difficulties. Management may be conservative (i.e., avoiding straining, improving defaecatory dynamics) or surgical. A number of surgical interventions may be employed depending on severity, comorbidities, and underlying physiology.
Polyvinylidene Fluoride Mesh Use in Laparoscopic Ventral Mesh Rectopexy in Patients with Obstructive Defecation Syndrome for the First Time
Published in Journal of Investigative Surgery, 2021
Mahdi Alemrajabi, Behnam Darabi, Behrouz Banivaheb, Nima Hemmati, Sepideh Jahanian, Mohammad Moradi
In total, 156 patients were included. One patient developed a postoperative abdominal pain. She developed fever on the second day after the operation and was reoperated due to generalized tenderness and signs of peritonitis. Second surgery via laparoscopy/laparotomy revealed a perforated diverticulitis. The mesh was removed and the patient received appropriate treatment and excluded from the study. Of 155 participants, 39 (25.2%) were male and 116 (74.8%) female. The mean ± SD age of participants was 45.61 ± 14.02 years. The mean ± SD duration of operation was 57.46 ± 7.37 minutes and the mean ± SD duration of hospital stay was 4.10 ± 1.78 days. Incontinence was present in 9% of patients in the first visit. Rectal bleeding and rectal prolapse were present in 14.2% and 13.5% of patients, respectively before the operation.
Surgical decision-making for rectal prolapse: one size does not fit all
Published in Postgraduate Medicine, 2020
Angela Lee, Cindy Kin, Raveen Syan, Arden Morris, Brooke Gurland
Rectal prolapse (RP) is a debilitating condition with both functional and anatomic changes. Patients, predominantly women, often experience a spectrum of symptoms including rectal pain, fecal incontinence (FI), and obstructed defecation. Rectal prolapse impacts primarily women and may coexist with concomitant pelvic organ prolapse, as seen in up to a third of patients [1]. Although not life-threatening, rectal prolapse and its sequelae can significantly impact the quality of life leading to isolation and depression.