eMedicine Specialties > Emergency Medicine > Gastrointestinal

Rectal Prolapse: Differential Diagnoses & Workup

Author: Lynn K Flowers, MD, MHA, FACEP, Physician Partner, ApolloMD, Atlanta, Georgia
Contributor Information and Disclosures

Updated: Nov 5, 2009

Differential Diagnoses

Hemorrhoids
Pediatrics, Intussusception
Proctitis

Other Problems to Be Considered

Rectal polyps

Workup

Laboratory Studies

  • Rectal prolapse is usually only a symptom, and evaluation should focus on discovery of an underlying disorder.
  • Perform a sweat chloride test for pediatric patients; as many as 11% of children with rectal prolapse have cystic fibrosis.
  • Consider a stool examination and culture for infectious agents, particularly in pediatric patients.

Imaging Studies

  • A barium enema (BE) can assess for concurrent colonic diseases or tumors.
  • Defecography may reveal intussusception of proximal colon or pelvic outlet obstruction.

Other Tests

  • Colonic transit study
  • Anal sphincter manometry (aids in determining the degree of anal sphincter damage)
  • Pudendal nerve terminal motor latency (assesses for neurologic injury or dysfunction)
  • Ultrasonography

Procedures

  • Proctosigmoidoscopy can be an important tool to examine rectal mucosa for ulceration, inflammation, or other contributing colonic disease.

More on Rectal Prolapse

Overview: Rectal Prolapse
Differential Diagnoses & Workup: Rectal Prolapse
Treatment & Medication: Rectal Prolapse
Follow-up: Rectal Prolapse
Multimedia: Rectal Prolapse
References
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References

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  2. Kairaluoma MV, Kellokumpu IH. Epidemiologic aspects of complete rectal prolapse. Scand J Surg. 2005;94(3):207-10. [Medline].

  3. Madiba TE, Baig MK, Wexner SD. Surgical management of rectal prolapse. Arch Surg. Jan 2005;140(1):63-73. [Medline].

  4. Marderstein EL, Delaney CP. Surgical management of rectal prolapse. Nat Clin Pract Gastroenterol Hepatol. Oct 2007;4(10):552-61. [Medline].

  5. Abcarian H. Prolapse and procidentia. In: Zuidema GD, ed. Shackelford's Surgery of the Alimentary Tract. 4th ed. WB Saunders Co; 1996:368-85.

  6. Bartolo DC. Rectal prolapse. Br J Surg. Jan 1996;83(1):3-5. [Medline].

  7. Boccasanta P, Rosati R, Venturi M, Montorsi M, Cioffi U, De Simone M, et al. Comparison of laparoscopic rectopexy with open technique in the treatment of complete rectal prolapse: clinical and functional results. Surg Laparosc Endosc. Dec 1998;8(6):460-5. [Medline].

  8. Coburn WM 3rd, Russell MA, Hofstetter WL. Sucrose as an aid to manual reduction of incarcerated rectal prolapse. Ann Emerg Med. Sep 1997;30(3):347-9. [Medline].

  9. Demirbas S, Ogün I, Celenk T, Akin ML, Erenoglu C, Yldz M. Early outcomes of laparoscopic procedures performed on military personnel with total rectal prolapse and follow-up. Surg Laparosc Endosc Percutan Tech. Aug 2004;14(4):194-200. [Medline].

  10. Fengler SA, Pearl RK, Prasad ML, Orsay CP, Cintron JR, Hambrick E, et al. Management of recurrent rectal prolapse. Dis Colon Rectum. Jul 1997;40(7):832-4. [Medline].

  11. Heine JA, Wong WD. Rectal prolapse. In: Mazier WP, ed. Surgery of the Colon, Rectum, and Anus. Harcourt Brace & Co; 1995:515-33.

  12. Hull TL, Milsom JW. Pelvic floor disorders. Surg Clin North Am. Dec 1994;74(6):1399-413. [Medline].

  13. Jacobs LK, Lin YJ, Orkin BA. The best operation for rectal prolapse. Surg Clin North Am. Feb 1997;77(1):49-70. [Medline].

  14. Siafakas C, Vottler TP, Andersen JM. Rectal prolapse in pediatrics. Clin Pediatr (Phila). Feb 1999;38(2):63-72. [Medline].

  15. Williams JG, Madoff RD. Perineal repair for rectal prolapse. In: Problems in General Surgery. Vol 9. 1992:732-8.

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Further Reading

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Keywords

rectal prolapse, rectal prolapse symptoms, rectal prolapse causes, rectal prolapse treatment, constipation, rectal pain, rectal bleeding, rectal ulceration, prolapsed rectum, fecal incontinence

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Contributor Information and Disclosures

Author

Lynn K Flowers, MD, MHA, FACEP, Physician Partner, ApolloMD, Atlanta, Georgia
Lynn K Flowers, MD, MHA, FACEP is a member of the following medical societies: American College of Emergency Physicians, American Medical Association, National Association of EMS Physicians, and Society for Academic Emergency Medicine
Disclosure: Nothing to disclose.

Medical Editor

Michael S Beeson, MD, MBA, FACEP, Professor of Emergency Medicine, Northeastern Ohio Universities College of Medicine and Pharmacy; Attending Faculty, Summa Health System
Michael S Beeson, MD, MBA, FACEP is a member of the following medical societies: American College of Emergency Physicians, Council of Emergency Medicine Residency Directors, National Association of EMS Physicians, and Society for Academic Emergency Medicine
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: eMedicine Salary Employment

Managing Editor

Eugene Hardin, MD, FAAEM, FACEP, Former Chair and Associate Professor, Department of Emergency Medicine, Charles Drew University of Medicine and Science; Former Chair, Department of Emergency Medicine, Martin Luther King Jr/Drew Medical Center
Disclosure: Nothing to disclose.

CME Editor

John D Halamka, MD, MS, Associate Professor of Medicine, Harvard Medical School, Beth Israel Deaconess Medical Center; Chief Information Officer, CareGroup Healthcare System and Harvard Medical School; Attending Physician, Division of Emergency Medicine, Beth Israel Deaconess Medical Center
John D Halamka, MD, MS is a member of the following medical societies: American College of Emergency Physicians, American Medical Informatics Association, Phi Beta Kappa, and Society for Academic Emergency Medicine
Disclosure: Nothing to disclose.

Chief Editor

Jonathan Adler, MD, Attending Physician, Department of Emergency Medicine, Massachusetts General Hospital; Division of Emergency Medicine, Harvard Medical School
Jonathan Adler, MD is a member of the following medical societies: American Academy of Emergency Medicine and Society for Academic Emergency Medicine
Disclosure: Nothing to disclose.

 
 
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