Prolapso rectal como presentación inhabitual de enfermedad celiaca. A propósito de 2 casos clínicos

Abstract

Introduction: Rectal prolapse (RP) is related to an increase of intra-abdominal pressure, pelvic floor disease or anal sphincter. The most common causes of RP are constipation, cystic fibrosis, whooping cough and dysenteric diarrhea. However, celiac disease is not considered among the pathologies related to RP. Objective: To present a scarcely described association between RP and celiac disease. Clinical Cases: We presented 2 preschoolers in whom the reason for consultation was RP, whose study was focused on as prolonged diarrhea, due to the antecedent of pasty consistency of stools. The tests showed elevated anti-tissue transglutaminase (anti-tTG) antibody titers, and duodenal biopsies with villous atrophy and increased intraepithelial lymphocytes, consistent with celiac disease. Both had an excellent response to the gluten-free diet, with rapid normalization of depositions, without presenting any episodes of RP after treatment. Both with normal staturo-ponderal development and anti-tTGnegative controls at the annual 5-year follow-up. Conclusions: Although the association between RP and celiac disease has not been described yet, it should be considered in diagnosis and treatment.