Rectal prolapse

Introduction Partial or full-thickness of the rectal wall is called rectal prolapse, and the rectal wall is partially moved down, that is, the rectal mucosa moves down, called mucosal prolapse or incomplete prolapse; the whole layer of the rectal wall is called full prolapse, If the descending rectal wall is called prolapsed in the rectal cavity of the anal canal; the lowering of the rectum to the anus is called external prolapse. The main symptom is the swelling of the mass from the anus. The tumor is small at the initial onset, and it is released when the bowel movement occurs, and then resets itself. After the tumor is removed from the gradual frequency, the volume is increased, and then the back of the anus should be carried by hand, accompanied by incomplete defecation and falling feeling. Finally, you can also get rid of coughing, exerting force and even standing. As the prolapse increases, causing varying degrees of anal incontinence, mucus often flows out, leading to eczema and itching of the perianal skin. Due to difficulty in rectal emptying, constipation often occurs, and the number of stools increases, which is like sheep feces. The mucous membrane is erosive and there is blood flowing out after the ulceration.

Cause

There are several factors that cause rectal prolapse.

(1) Anatomical factors

The curvature of the appendix in children is shallower than normal, and the rectum is vertical. When the intra-abdominal pressure is increased, the rectum loses the support of the tibia and is prone to prolapse. In some adults, the peritoneum of the rectal recess is lower than normal. When the intra-abdominal pressure is increased, the intestinal fistula is directly pressed against the anterior wall of the rectum to push it down, which may lead to rectal prolapse.

(2) The pelvic floor tissue is weak

Older people have muscle relaxation, women have too much childbirth and perineal tears during childbirth. Incomplete development of children can cause levator ani muscle and pelvic floor fascia dysplasia, atrophy, and can not support the rectum in the normal position.

(3) Increased long-term intra-abdominal pressure

Such as long-term constipation, chronic diarrhea, prostatic hypertrophy caused by dysuria, chronic bronchitis caused by chronic cough and other factors, can cause rectal prolapse.

an examination

Related inspection

Anal finger examination, rectal examination, anal examination

The diagnosis of rectal prolapse is not difficult. The patient underarms can do defecation, and the abdominal muscles can be used for prolapse. Partial prolapse shows a round, red, smooth surface mass, the mucous membrane is "radial" wrinkled, soft, and retracted after defecation. If it is complete, it will be prolonged, and the exudate will be pagoda-like or spherical, and the surface of the rectal mucosa can be seen on the surface. The rectal examination shows that the sphincter is weak. If there is a small intestine in the prolapse, sometimes the bowel sounds can be heard.

Differential diagnosis

Differential diagnosis of rectal prolapse:

Rectal prolapse needs to be differentiated from the annular internal hemorrhoids. In addition to the different medical history, when the annular internal hemorrhoids prolapsed, the hypertrophic sputum mass was observed, which was plum-like, prone to hemorrhage, and a concave normal mucosa appeared between the sacral blocks. Rectal examination, sphincter contraction is strong, and rectal prolapse is slack, which is an important point of identification.

The diagnosis of rectal prolapse is not difficult. The patient underarms can do defecation, and the abdominal muscles can be used for prolapse. Partial prolapse shows a round, red, smooth surface mass, the mucous membrane is "radial" wrinkled, soft, and retracted after defecation. If it is complete, it will be prolonged, and the exudate will be pagoda-like or spherical, and the surface of the rectal mucosa can be seen on the surface. The rectal examination shows that the sphincter is weak. If there is a small intestine in the prolapse, sometimes the bowel sounds can be heard.

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