Muhammad Ishfaq, Asif Javeed, Mas Ood Mazhar.
Rectal Prolapse in Children: Management of Early Presented, Maltreated and Relapsed Cases.
Pak J Med Health Sci Jan ;12(1):215-7.

Aim : To analyze and compare the results of management of early presented, late and relapsed complicated cases of rectal prolapse in pediatric age group and to make a protocol according to the clinical condition, duration and severity of disease. Study design :- Descriptive and prospective study. Place and duration :- Children complex, Ibn-e-Siena Hospital and Research Institute of Multan Medical and Dental College, Multan from June 2013 to January 2017. Methodology :- A total no. of 43 patients , up to the age of 12 years , diagnosed as the cases of rectal prolapse were admitted and managed conservatively as well as surgically. Results : Out of 43 cases with rectal prolapse , 2 cases were initially diagnosed with rectal polyps cured with polypectomy. In remaining cases conservative management of early presented cases-15. Old maltreated relapsed cases – 26. Relieved with conservative management – 13. Relapsed after conservative management – 2. Thiersch stitch was applied in 16 cases. Successful in 13 cases and failure in 3 cases. Waiting for further management – 18. Sclerosing injection therapy applied in 15 cases. 12 cases were cured. The remaining 3 complicated cases were managed with Delorme’s operation. Conclusion :- Conservative measures are the best for the early presented cases. The initial surgical procedure recommended in early presented cases not relieved after conservative management is Thiersch stitch. In maltreated, relapsed and with congenital anomalies, sclerosing injection therapy is the procedure of choice. Major surgical procedures are rarely used and are reserved only after the very critical cases.

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