Pediatric Rectal Prolapse Differential Diagnoses

Updated: Dec 12, 2019
  • Author: Jaime Shalkow, MD, FACS; Chief Editor: Carmen Cuffari, MD  more...
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DDx

Diagnostic Considerations

Other differential diagnoses include the following:

  • Prolapsing rectal polyp: Appears with defecation and reduces spontaneously; the lesion does not involve the entire circumference; patients with recurring rectal prolapse with no apparent cause or history of rectal bleeding should undergo proctosigmoidoscopy to rule out polyps.

Ileocecal intussusception: Differential diagnosis should be clear based on history and physical examination findings. Patients with intussusception are often much more ill appearing on presentation and complain of severe abdominal pain.

  • Submucosal venous congestion secondary to straining: May manifest as an intermittently appearing anal lesion and might be confused with rectal prolapse.
  • Hemorrhoids: Seldom seen in pediatric patients except in the setting of portal hypertension
  • Rectal tumors – Uncommon in children.

Other rare sequelae of rectal prolapse include solitary rectal ulcer syndrome  [31]   and inflammatory cloacogenic polyp. Both are due to ischemia and quite rare in children. In patients with history of significant bleeding, endoscopy should be considered to identify the source [34] .