Rectal prolapse of intussusception--a single institution's experience

Area of Science:

• Pediatric Surgery
• Gastroenterology

Background:

• Intussusception is a common surgical emergency in infants and children.
• Rectal prolapse can be a presenting sign of intussusception, but is not always accompanied by classic symptoms.

Purpose of the Study:

• To investigate the clinical presentation and outcomes of intussusception presenting as rectal prolapse in pediatric patients.
• To determine the efficacy of air enema reduction in these cases.

Main Methods:

• Retrospective analysis of 198 children with intussusception over a 5-year period.
• Focused study on the 16 children who presented with intussusception prolapsing rectally.

Main Results:

• Rectal prolapsing intussusception occurred in 8% of cases, primarily in infants (average age 5 months).
• Common symptoms included rectal bleeding and abdominal mass; abdominal pain was present in only 56%.
• Air enema reduction (AER) was successful in 57% of attempted cases (8/14), with one perforation complication. Manual reduction was used for refractory cases.

Conclusions:

• Rectal prolapsing intussusception can present atypically, necessitating a high clinical suspicion for diagnosis.
• Air enema reduction is a viable and often successful initial treatment modality when no contraindications exist.
• No recurrences were observed in this series, suggesting good outcomes with appropriate management.