Internal recto-anal intussusception Type 2W Wide Lumen Type 2M Narrowed internal lumen with associated rectal hyposensitivity or early megarectum Type 3: This may progress to a chronically prolapsed and severe condition, defined as spontaneous prolapse that is difficult to keep inside, and occurs with walking, prolonged standing,  coughing or sneezing Valsalva maneuvers. In full thickness rectal prolapse, these folds run circumferential. Classification[ edit ] A. Decreased squeeze and resting pressures are usually the findings, and this may predate the development of the prolapse. It includes solitary rectal ulcer syndrome, rectal prolapse, proctitis cystica profunda, and inflammatory polyps.
This may progress to a chronically prolapsed and severe condition, defined as spontaneous prolapse that is difficult to keep inside, and occurs with walking, prolonged standing,  coughing or sneezing Valsalva maneuvers. Anatomical differences such as the wider pelvic outlet in females may explain the skewed gender distribution. The appearance is of a reddened, proboscis-like object through the anal sphincters. Furthermore, in rectal prolapse, there is a sulcus present between the prolapsed bowel and the anal verge, whereas in hemorrhoidal disease there is no sulcus. Rectal prolapse and internal rectal intussusception has been classified according to the size of the prolapsed section of rectum, a function of rectal mobility from the sacrum and infolding of the rectum. External complete rectal prolapse rectal procidentia, full thickness rectal prolapse, external rectal prolapse is a full thickness, circumferential, true intussusception of the rectal wall which protrudes from the anus and is visible externally. The height of intussusception from the anal canal is usually estimated by defecography. Decreased squeeze and resting pressures are usually the findings, and this may predate the development of the prolapse. Internal-external recto-anal intussusception History[ edit ] Patients may have associated gynecological conditions which may require multidisciplinary management. Internal recto-rectal intussusception Type 1W Wide lumen Type 2: However, the clinical significance of the findings are disputed by some. Internal recto-anal intussusception Type 2W Wide Lumen Type 2M Narrowed internal lumen with associated rectal hyposensitivity or early megarectum Type 3: The parameters of this classification are anatomic descent, diameter of intussuscepted bowel, associated rectal hyposensitivity and associated delayed colonic transit: Classification[ edit ] A. It includes solitary rectal ulcer syndrome, rectal prolapse, proctitis cystica profunda, and inflammatory polyps. Physical examination[ edit ] Rectal prolapse may be confused easily with prolapsing hemorrhoids. Fecal incontinence may also influence the choice of management. As most sufferers are elderly, the condition is generally under-reported. It is rare in men over 45 and in women under Shortly after the invention of defecography , In Broden and Snellman used cinedefecography to show that rectal prolapse begins as a circumferential intussusception of the rectum,   which slowly increases over time. Full length colonoscopy is usually carried out in adults prior to any surgical intervention. There is some controversy surrounding this condition as to its relationship with hemorrhoidal disease, or whether it is a separate entity. Mucosal prolapse partial rectal mucosal prolapse  refers to prolapse of the loosening of the submucosal attachments to the muscularis propria of the distal rectummucosal layer of the rectal wall. In mucosal prolapse, these folds are radially. This classification also takes into account sphincter relaxation: Essentially, rectal prolapses may be full thickness complete , where all the layers of the rectal wall prolapse, or involve the mucosal layer only partial external if they protrude from the anus and are visible externally, or internal if they do not circumferential, where the whole circumference of the rectal wall prolapse, or segmental if only parts of the circumference of the rectal wall prolapse present at rest, or occurring during straining.
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