Rehabilitative treatment for internal rectal prolapse

Abstract

Internal rectal prolapse is a full-thickness intussusception of the rectal wall without protrusion beyond the anal canal as demonstrated on defecography [1]. The presence of full-thickness intussusception at defecography may be suspected when intussusception thickness is greater than 3 mm [2]. Internal rectal prolapse is important because it may represent the first stage leading to overt rectal prolapse [3, 4]. Rectal prolapse could be the end point of a full-thickness circumferential intussusception that began as a rectorectal intussusception at ≈8 cm from the anal verge, evolved into a rectoanal intussusception, and finally into an overt rectal prolapse everting outside the perineum. Precise proctography measures indicate that the take-off point of the intussusception appears at about 5.5 cm from the anorectal junction anteriorly [5]. In this way, internal rectal prolapse may be related to two different morphological aspects, which are surely a function of the time spectrum, firstly, for example, rectorectal intussusception, and secondly, rectoanal intussusception. © 2008 Springer-Verlag Italia.