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Pediatric Rectal Prolapse: A Case Report
Melissa A Mallary1, Bansri S Patel2, Victoria M Arredondo2
1Emergency Medicine, A.T. Still University - School of Osteopathic Medicine in Arizona, Mesa, USA.
Insights
Rectal prolapse is uncommon in healthy children over four years old. This case highlights the importance of physical exams and investigating potential underlying causes in older children presenting with this condition.
Area of Science:
- Pediatric Gastroenterology
- Colorectal Surgery
Background:
- Rectal prolapse in children typically occurs without pre-existing conditions.
- It is uncommon in children over the age of four without underlying etiologies.
Observation:
- A previously healthy five-year-old female presented with a three-day history of constipation, hard stools, and painful defecation.
- Physical examination revealed a rectal prolapse.
Findings:
- The patient's presentation of rectal prolapse at age five, without prior health issues, is unusual.
- Referral to pediatric gastroenterology was made due to the rarity of the condition in this demographic.
Implications:
- This case underscores the critical role of physical examination in diagnosing rectal prolapse.
- It emphasizes the necessity of investigating potential underlying neurological or musculoskeletal conditions in older children with rectal prolapse, as intervention may be required.
Abstract:
In the absence of preexisting conditions, rectal prolapse is rarely seen in children older than four years old. This case report presents a peculiar instance involving a previously healthy five-year-old female who presented to the clinic with her parents due to a three-day history of constipation, hard stools, and painful defecation. Physical examination revealed a rectal prolapse. Given the infrequency of rectal prolapse without underlying conditions in this age group, the patient was referred to a tertiary emergency department at the children's hospital to be evaluated by pediatric gastroenterology. Most rectal prolapse cases in children resolve without intervention; however, in children over the age of four, it may require surgery due to the likelihood of an underlying neurological or musculoskeletal condition. This case emphasizes the value of a thorough physical examination to detect the finding and stresses the importance of ruling out a more serious etiology.
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