A Child presented with a long history of rectal prolapse of around 6cm, which was reducible. The treatment of choice is –(AIIMS Nov 2012)
Treatment of rectal prolapse in a child.
a. Digital reposition: The parent must be taught to replace the protrusion. The distal two thirds of the index finger is srapped in tissue paper. The finger is inserted into the protrusion and the mass is eased into place. Gently, the finger is withdrawn, leaving the tissue paper to disintegrate. In cases of malnutrition, dietetic adjustments are necessary.
b. Submucous injections: If digital reposition fails after 6 weeks’ trial, injections of 5% phenol in almond oil are carried out under general anaesthesia. As a result of the aseptic inflammation following these injections, the mucous membrane becomes tethered to the muscle coat.
c. Surgery: Occasionally, surgery is required, and in such cases the child is placed in the prone jack-knife position, the retro rectal space is entered and the rectum is sutured to the sacrum.