Stubborn rectal prolapse in systemic sclerosis.

Area of Science:

• Gastroenterology and Autoimmune Diseases

Background:

• Systemic sclerosis (SSc) is an autoimmune connective tissue disorder.
• Anorectal manifestations in SSc can include fecal incontinence and rectal prolapse.
• These symptoms may indicate a specific SSc-related rectal prolapse syndrome.

Purpose of the Study:

• To describe the clinical presentation and surgical outcomes of rectal prolapse in patients with Systemic Sclerosis.
• To highlight the association between SSc, fecal incontinence, and rectal prolapse.

Main Methods:

• Case report of three female patients with Systemic Sclerosis.
• Description of presenting symptoms, including fecal incontinence and rectal prolapse/intussusception.
• Review of surgical interventions and outcomes, noting recurrence and persistent incontinence.

Main Results:

• All three patients presented with fecal incontinence and rectal prolapse/intussusception after a mean history of 10 years of SSc.
• Rectal prolapse recurred in all patients despite initial surgical procedures.
• Fecal incontinence persisted in all patients even after prolapse removal.

Conclusions:

• Systemic sclerosis-associated rectal prolapse syndrome may present earlier and involve ventral rectal wall prolapse.
• High recurrence rates of rectal prolapse and persistent fecal incontinence are characteristic of SSc patients post-surgery.
• Fecal incontinence in SSc patients should prompt investigation for associated rectal prolapse.