Short-Term Successful Conservative Management of a Rare Full-Thickness Rectal Prolapse in an Adolescent from a...

Full-thickness rectal prolapse is rarely seen in adolescents, and when it does occur, it often suggests a specific underlying trigger rather than the benign, self-limited cases typical in younger children. Constipation, infections, nutritional issues, and anatomic or functional disorders are among the common contributors, making a careful assessment important when older children present with prolapse.

A 14-year-old boy arrived with a sudden rectal mass that appeared after marked straining during a bowel movement. He had experienced a week of constipation with hard stools and prolonged time on the toilet but had no history of illness, infection, or weight-related concerns. Examination showed a circumferential, full-thickness prolapse that remained healthy and viable. Laboratory tests were normal, and stool studies for parasites were negative. Gentle manual reduction was successfully performed, and he was started on stool softeners, hydration guidance, and a high-fiber diet. He recovered well, and no recurrence was observed during a four-week follow-up period.

This case underscores the importance of recognizing that prolapse in adolescents often has a functional cause, even in settings where infections and malnutrition are more common. The patient's history of significant straining made functional constipation the most reasonable explanation. His rapid improvement also emphasizes how effective simple, conservative measures can be.

Although full-thickness rectal prolapse is unusual in adolescents, timely reduction combined with focused bowel management can lead to excellent outcomes. Early recognition and supportive care remain central to preventing recurrence. However, continued follow-up is essential to monitor for potential relapse, particularly in adolescent patients.