The cause of rectal prolapse in children
W. T. Zempsky and B. J. Rosenstein
Johns Hopkins Hospital Cystic Fibrosis Center, Johns Hopkins University, Baltimore, MD.
Fifty-four pediatric patients with rectal prolapse (RP) were identified by
review of medical records from 1977 to 1987. Rectal prolapse was attributed
to chronic constipation (15 patients), acute diarrheal disease (11
patients), cystic fibrosis (CF) (six patients), and neurologic/anatomic
abnormalities (13 patients). In nine patients, no underlying cause was
identified. The patients with CF did not differ from the other groups in
terms of age at time of onset of prolapse, growth measurements, or number
of episodes of prolapse. All patients with CF had a history of
abnormalities or presented with signs and symptoms consistent with this
diagnosis; none had a history of constipation. Although physicians can be
reassured that CF is not a likely diagnosis in patients with RP and acute
diarrheal disease or a clear history of constipation, a sweat test is
indicated in all such cases as well as in those in which there is no
apparent underlying cause. A sweat test is not usually indicated in
patients with RP in association with underlying anatomic abnormalities.
