Abstract
Purpose: Rectal prolapse is a relatively common condition in children, with most cases responding to conservative management. A characteristic finding in fluoroscopic contrast enema was observed. We herein report this finding and the difference in this finding between conservative and surgical cases.
Methods: We retrospectively reviewed the cases of 18 patients who had consulted our hospital regarding rectal prolapse between January 2005 and December 2014. The onset, first consultation, symptoms, findings of contrast enema, and results of treatment were obtained from medical records.
Results: The median ages at onset and first consultation were 3.4 and 5.0 years old, respectively. Six patients had constipation, 9 experienced excessive strain upon defecation, and 3 had bloody stools. Eight patients responded to conservative management, whereas 10 patients required surgery. No significant differences were observed in the ages at onset and first consultation, or symptoms between the conservative and surgical cases. We observed that the rectum dropped apart from the sacrum in contrast enema. This finding was defined as insufficient fixation of the rectum. The insufficient fixation spread to the second or third sacrum in the cases treated surgically, but was limited to the first sacrum in those treated conservatively. No recurrent prolapse occurred in both cases treated conservatively and surgically.
Conclusions: Insufficient fixation of the rectum to the sacrum was observed in all the patients, which may affect rectal prolapse. Furthermore, the effectiveness of conservative management appeared to depend on the extent of insufficiency. Rectopexy is an effective procedure because it restores this anatomical disorder.
