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<p>Pediatric rectal prolapse is characterized by the external telescoping of the rectal wall through the anus and is most common in children under 5&#xa0;years of age due to their anatomical predisposition. Underlying conditions include chronic constipation, gastrointestinal infections, malnutrition, neurological disorders, and rare conditions like Hirschsprung’s disease and cystic fibrosis. Most cases resolve spontaneously (60–90%), and the mainstay of medical treatment is bowel management including increased fluid and fiber intake, good toileting habits, and stool softeners/laxatives. Persistent or severe cases, particularly in children presenting after 5&#xa0;years of age, have a&#xa0;lower success rate of medical management and more often require surgical management. Sclerotherapy is considered a&#xa0;first-line option due to its minimally invasive nature and acceptable safety profile. Approximately 80% of children have permanent success after just 1–2&#xa0;injections but the success rate varies depending on the sclerosing agent and injection protocol. More invasive surgical interventions, including Thiersch cerclage, perineal procedures, and rectopexy are reserved for advanced cases. The application of mesh-reinforced rectopexy and “resection rectopexy” in children remains subject of debate. To date, time-point and type of surgical procedure lack standardization due to limited procedural frequency of severe pediatric rectal prolapse and is mainly based on the surgeon’s experience. Further research is essential to establish evidence-based guidelines and improve management strategies.</p>

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Kindlicher Rektumprolaps

  • 期刊论文

  • 发表日期：

    2025年5月16日

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  • Marietta Jank,
  • Michael Boettcher

摘要

Pediatric rectal prolapse is characterized by the external telescoping of the rectal wall through the anus and is most common in children under 5 years of age due to their anatomical predisposition. Underlying conditions include chronic constipation, gastrointestinal infections, malnutrition, neurological disorders, and rare conditions like Hirschsprung’s disease and cystic fibrosis. Most cases resolve spontaneously (60–90%), and the mainstay of medical treatment is bowel management including increased fluid and fiber intake, good toileting habits, and stool softeners/laxatives. Persistent or severe cases, particularly in children presenting after 5 years of age, have a lower success rate of medical management and more often require surgical management. Sclerotherapy is considered a first-line option due to its minimally invasive nature and acceptable safety profile. Approximately 80% of children have permanent success after just 1–2 injections but the success rate varies depending on the sclerosing agent and injection protocol. More invasive surgical interventions, including Thiersch cerclage, perineal procedures, and rectopexy are reserved for advanced cases. The application of mesh-reinforced rectopexy and “resection rectopexy” in children remains subject of debate. To date, time-point and type of surgical procedure lack standardization due to limited procedural frequency of severe pediatric rectal prolapse and is mainly based on the surgeon’s experience. Further research is essential to establish evidence-based guidelines and improve management strategies.