Rectal prolapse
The rectal prolapse or rectal prolapse is a prolapse of the rectum or an intussusception of the rectum entire wall, or only the rectal mucosa in the rectum and clearing through the anus to the outside. It is the prolapse of all layers of the rectum . The rectal prolapse may occur in combination with the anal prolapse, called anal prolapse or prolapsus ani et recti . As a partially limited mucosal prolapse, e.g. B. after sclerotherapy of hemorrhoids , it is called rectum metropion. In a broader sense, one also speaks of a sliding hernia of the pelvic floor. Rectal prolapse is common in women and multiparous women. Chronic constipation is also suspected to be a contributing factor.
Symptoms
- Bowel prolapse
- Oozing
- Blood loss
- Mucus discharge
Possible forms of therapy
- transabdominal rectopexy or resection rectopexy
- Resection of the invaginate (in case of incarceration)
- transperineal (transanal) rectosigmoid resection according to Altemeier
- transperineal (transanal) mucosal resection according to Rehn-Delormes
- sublevatory implantation of a wire ring according to Tiersch (for high-risk patients)
Types of rectal prolapse
In rectal prolapse, a distinction is made between internal prolapse on the one hand and external prolapse on the other. The "internal rectal prolapse" is a cylindrical invagination of the mucous membrane of the upper rectal sections into the rectal clearing without protruding from the anus. It leads to constipation, but also to fluid, fatty and possibly bloody stools. An "external prolapse", on the other hand, is understood to mean a circular protrusion of all intestinal layers out of the anus.
swell
- Pschyrembel, Clinical Dictionary. 257th edition. Verlag Walter de Gruyter, Berlin / New York 1994, ISBN 3-11-014183-3 .
further reading
- S. Tou, SR Brown, AI Malik, RL Nelson: Surgery for complete rectal prolapse in adults. In: Cochrane database of systematic reviews (online). Number 4, 2008, p. CD001758, ISSN 1469-493X . doi: 10.1002 / 14651858.CD001758.pub2 . PMID 18843623 . (Review).
- EL Marderstein, CP Delaney: Surgical management of rectal prolapse. In: Nature Clinical Practice Gastroenterology & Hepatology Volume 4, Number 10, October 2007, pp. 552-561, ISSN 1743-4386 . doi: 10.1038 / ncpgasthep0952 . PMID 17909532 . (Review).
- KE Matzel, S. Heuer, W. Zhang: Rectal Prolapse - Abdominal or Local Procedure. In: The surgeon. Volume 79, Number 5, May 2008, pp. 444-451, ISSN 0009-4722 . doi: 10.1007 / s00104-008-1546-2 . PMID 18418563 . (Review).
Individual evidence
- ↑ Stefan Eisoldt: Case book surgery. Thieme, Stuttgart 2014, ISBN 978-3-13-132214-2 , case 29.
- ↑ Wolfgang F. Caspary, Joachim Mössner, Jürgen Stein (eds.): Therapy of gastroenterological diseases. Springer, Heidelberg 2005, ISBN 3-540-44174-3 , p. 369.
