Rectal prolapse pathophysiology: Difference between revisions
No edit summary |
|||
| Line 12: | Line 12: | ||
In severe cases, the large mass cannot reduce spontaneously, and may become incarcerated or strangulatied. Both complete rectal prolapse and internal intussusception can occur independently or can be associated with the descent of other pelvic organs, e.g., uterine or vaginal vault prolapse. Pre-existing dyssynergic defecation that cause chronic excessive straining may coexist. | In severe cases, the large mass cannot reduce spontaneously, and may become incarcerated or strangulatied. Both complete rectal prolapse and internal intussusception can occur independently or can be associated with the descent of other pelvic organs, e.g., uterine or vaginal vault prolapse. Pre-existing dyssynergic defecation that cause chronic excessive straining may coexist. | ||
==Associated Conditions== | ==Associated Conditions== | ||
Revision as of 16:48, 31 January 2018
|
Rectal prolapse Microchapters |
|
Diagnosis |
|---|
|
Treatment |
|
Case Studies |
|
Rectal prolapse pathophysiology On the Web |
|
American Roentgen Ray Society Images of Rectal prolapse pathophysiology |
|
Risk calculators and risk factors for Rectal prolapse pathophysiology |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Shaghayegh Habibi, M.D.[2]
Overview
Pathophysiology
Pathogenesis
The evolution of rectal prolapse starts from excessive straining over time leading to the laxity or weakness of pelvic floor muscles. Over time this leads to connective tissue injury including nerve injury and neuropathy of the pelvic floor with loss of counter-acting resistive force during defecation, thereby leading to rectal intussusception initially, followed by external mucosal prolapse, and eventually a full protrusion of all layers of the rectal wall through the anus. Most patients with rectal prolapse present with anal protrusion, rectal pain, bloody or mucous passage, symptoms of fecal incontinence or obstructed defecation.
In severe cases, the large mass cannot reduce spontaneously, and may become incarcerated or strangulatied. Both complete rectal prolapse and internal intussusception can occur independently or can be associated with the descent of other pelvic organs, e.g., uterine or vaginal vault prolapse. Pre-existing dyssynergic defecation that cause chronic excessive straining may coexist.
Associated Conditions
Rectal prolapse is associated with several coexisting anatomic abnormalities:[1]
- Diastasis of the levator ani
- Abnormally deep cul-de-sac
- Redundant sigmoid colon
- Patulous anal sphincter
- Loss or attenuation of the rectal sacral attachments
References
- ↑ Bordeianou L, Paquette I, Johnson E, Holubar SD, Gaertner W, Feingold DL, Steele SR (2017). "Clinical Practice Guidelines for the Treatment of Rectal Prolapse". Dis. Colon Rectum. 60 (11): 1121–1131. doi:10.1097/DCR.0000000000000889. PMID 28991074.