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Anorectal motility in children with complete rectal prolapse
H Suzuki1, S Amano, K Matsumoto
1Second Department of Surgery, Mie University School of Medicine, Tsu City, Japan.
Progress in Pediatric Surgery
|January 1, 1989
Summary
Children with rectal prolapse showed reduced smooth muscle function in the anal canal. Defecography and ultrasonography revealed intussusception as the initial stage, with conservative treatment successful in most cases.
Area of Science:
- Pediatric Gastroenterology
- Colorectal Surgery
- Diagnostic Imaging
Background:
- Complete rectal prolapse is a condition affecting children, with unclear underlying mechanisms.
- Previous studies have explored various diagnostic methods, but a comprehensive understanding of anorectal function and prolapse initiation is lacking.
Purpose of the Study:
- To investigate anorectal manometry, defecography, and ultrasonographic findings in children with complete rectal prolapse.
- To determine the initial mechanism of rectal prolapse development.
- To evaluate the efficacy of conservative and surgical treatments.
Main Methods:
- Anorectal manometry, defecography, and ultrasonography were performed on 36 children with complete rectal prolapse and 45 controls.
- Analysis focused on pressures (Pr, Pac), high-pressure zone (HPZ) length, and basal rectoanal canal (BRC) contraction rates.
- Imaging studies assessed the initial stages of rectal prolapse.
Main Results:
- No significant differences in resting pressure (Pr), squeeze pressure (Pac), or HPZ length were found between patients and controls.
- Patients exhibited significantly lower BRC rates of the anal canal smooth muscle and rectoanal canal (RC).
- Defecography and ultrasonography confirmed rectal intussusception as the initial event in prolapse development.
Conclusions:
- Reduced anal canal smooth muscle contractility is associated with rectal prolapse in children.
- Rectal intussusception is the initiating factor in the development of complete rectal prolapse.
- Conservative management is effective in the majority of cases, with satisfactory outcomes from modified Sudeck's operation when surgery is required.