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[Total rectal prolapse in children. Diagnostic and therapeutic trends. Statistics apropos of 52 cases]
T Scheye1, G Vanneuville, D Marouby
1Service de Chirurgie Infantile, CHU Clermont-Ferrand.
Insights
Rectal procidentia in children is often underdiagnosed but typically resolves spontaneously. Surgery is reserved for severe or complicated cases, with the modified Lockhart-Mummery procedure showing satisfactory outcomes.
Area of Science:
- Pediatric Surgery
- Gastroenterology
Background:
- Rectal procidentia is a rare condition, accounting for only 2% of rectal prolapse in children.
- Diagnosis is often delayed, as peritoneography can reveal increased rectogenital pouch migration, suggesting higher prevalence.
Purpose of the Study:
- To evaluate the diagnostic and therapeutic approaches for rectal procidentia in pediatric patients.
- To assess the efficacy of surgical intervention for confirmed or complicated cases.
Main Methods:
- Analysis of 52 pediatric cases of rectal procidentia.
- Review of diagnostic methods, including peritoneography.
- Evaluation of surgical outcomes for the modified Lockhart-Mummery procedure.
Main Results:
- Peritoneography aids in more frequent diagnosis of rectal procidentia.
- Most cases in infants and young children exhibit spontaneous healing, even with potential strangulation.
- The modified Lockhart-Mummery procedure was preferred for surgical cases.
Conclusions:
- Rectal procidentia is likely more common than classically reported.
- Conservative management is often appropriate due to the tendency for spontaneous resolution.
- Surgical intervention, particularly the modified Lockhart-Mummery procedure, yields satisfactory results in indicated cases.
Abstract:
Rectal procidentia represents classically only 2% of rectal prolapse in children. This rarity is more apparent than real, because peritoneographies showing the excess of migration of the rectogenital pouch, allows to diagnose more often this pathology. The normal trend of this anomaly of the infant and the young child even if it could be serious with strangulation is usually a spontaneous healing. Accordingly therapeutic indications should be cautious. Surgery is only indicated in confirmed or complicated forms. After analysis of the statistic of 52 observations, the modified Lockhart-Mummery is our prefered procedure. It needs a short and simple surgery and the results appear satisfactory.