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Difference between revisions of "Rectal prolapse"
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'''Rectal prolapse''' is a benign pathology of the [[rectum]], typically seen in women that are multiparous and postmenopausal. | |||
==General== | |||
*Usually close to the anal verge. | |||
*Rare forms can occasionally be confused with [[colorectal carcinoma|cancer]].<ref name=pmid19861563>{{cite journal |author=Brosens LA, Montgomery EA, Bhagavan BS, Offerhaus GJ, Giardiello FM |title=Mucosal prolapse syndrome presenting as rectal polyposis |journal=J. Clin. Pathol. |volume=62 |issue=11 |pages=1034–6 |year=2009 |month=November |pmid=19861563 |pmc=2853932 |doi=10.1136/jcp.2009.067801 |url=}}</ref> | |||
Epidemiology: | |||
*~90% women, postmenopausal and multiparous.<ref name=pmid22413077>{{Cite journal | last1 = Lee | first1 = S. | last2 = Kye | first2 = BH. | last3 = Kim | first3 = HJ. | last4 = Cho | first4 = HM. | last5 = Kim | first5 = JG. | title = Delorme's Procedure for Complete Rectal Prolapse: Does It Still Have It's Own Role? | journal = J Korean Soc Coloproctol | volume = 28 | issue = 1 | pages = 13-8 | month = Feb | year = 2012 | doi = 10.3393/jksc.2012.28.1.13 | PMID = 22413077 }}</ref> | |||
Treatment: | |||
*Surgical: | |||
**Delorme procedure = mucosa stripped. | |||
==Microscopic== | |||
Features:<ref name=pmid3234303>{{cite journal |author=Schneider A, Fritze C, Bosseckert H, Machnik G |title=[Primary clinical, endoscopic and histologic findings in solitary rectal ulcer] |language=German |journal=Dtsch Z Verdau Stoffwechselkr |volume=48 |issue=3-4 |pages=183–9 |year=1988 |pmid=3234303 |doi= |url=}}</ref> | |||
*"Fibromuscular hyperplasia" - '''key feature''': | |||
**Fibrosis (submucosa, lamina propria). | |||
**Muscularis mucosae is "too superficial" (muscle in the lamina propria). | |||
*Surface ulceration + inflammation ([[neutrophil]]s). | |||
*+/-Serration of epithelium at the surface. | |||
Notes: | |||
*'''Important negative''': no nuclear atypia. | |||
===Images=== | |||
<gallery> | |||
Image:Rectal_prolapse_-_low_mag.jpg | Rectal prolapse - low mag. (WC/Nephon) | |||
Image:Rectal_prolapse_-_intermed_mag.jpg | Rectal prolapse - intermed. mag. (WC/Nephron) | |||
</gallery> | |||
==Sign out== | |||
<pre> | |||
RECTAL MUCOSA, DELORME PROCEDURE: | |||
- SUPERFICIAL RECTAL WALL WITH FIBROMUSCULAR HYPERPLASIA AND EDEMA. | |||
- NEGATIVE FOR DYSPLASIA AND NEGATIVE FOR MALIGNANCY. | |||
</pre> | |||
===Micro=== | |||
The sections show rectal mucosa, submucosa and a small amount of muscularis propria. The mucosa shows fibromuscular hyperplasia with thickening of the muscularis mucosae and mild lamina propria fibrosis. The submucosa is edematous. The small amount of muscularis propria is unremarkable. The epithelium matures normally to the surface. No significant nuclear atypia is identified. | |||
==See also== | |||
*[[Rectum]]. | |||
==References== | |||
{{Reflist|2}} | |||
[[Category:Gastrointestinal pathology]] | |||
[[Category:Diagnosis]] | [[Category:Diagnosis]] | ||