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A 56-year-old male presented to the emergency department with a feeling of heaviness and a protruding mass at the anal verge associated with pruritus in this area. The patient did not feel any pain and did not report experiencing faecal incontinence. Physical examination resulted in the visual diagnosis of a total rectal prolapse. Immediate manual repositioning through gentle pressure succeeded and the patient was scheduled for an elective laparoscopic ventral rectopexy. Total rectal prolapse, or full-thickness rectal prolapse (procidentia), is defined as protrusion of the rectum beyond the anus. The entire rectal wall can be palpated in the externalized tissue exhibiting circular plication. Thus, a less distinct rectal prolapse can be distinguished visually from an anal mucosal prolapse as the latter shows stellate plication. Symptomatic patients having difficulties in reduction, substantial incontinence or obstructed defecation are to be referred for consideration of surgery.

Citation

Tobias S Schiergens, Michael N Thomas, Wolfgang E Thasler. Rectal prolapse. Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract. 2012 Dec;16(12):2336-7

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PMID: 23054898

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