Rectal Procidentia—A Rare Complication of Ulcerative Colitis

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IN common usage the term ‘prolapse of rectum’ may refer either to prolapse or to procidentia of the rectum. Prolapse by definition is the abnormal descent of only rectal mucous membrane with protrusion through the anus. The mucosal furrows radiate from the center of the anal aperture. Procidentia refers to the abnormal descent of all layers of the rectum or sigmoid with protrusion, usually two or more inches beyond the anus. Folds of mucosa are concentrically arranged.

The occurrence of rectal procidentia as a complication of chronic ulcerative colitis in childhood is evidently rare. It has been mentioned as a complication of chronic ulcerative colitis by Edwards and Truelove,1 who found it to occur in eight patients in their series of 624, but chiefly in the age range of 25 to 40 years. Rectal prolapse but not rectal procidentia in ulcerative colitis was noted by Davidson2 in 1964. In the last 12 years, 125 children with the diagnosis of ulcerative colitis have been seen at the Cleveland Clinic, in only two of whom rectal procidentia was observed as a complication of the disease.

Report of Cases

Case 1. A 5¾-year-old boy was admitted to the Cleveland Clinic Hospital on July 10, 1965, because of bleeding from the rectum after each bowel movement for the last seven months. He had from one to four loose, foul-smelling movements daily, and particles of undigested food and mucus were visible in the feces. In the week before admission to the hospital, painful swelling and. . .



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