The combination of sclerotherapy and anal cerclage: treatment of choice for rectal prolapse in children?

Abstract

Background: Mucosal prolapse of the rectum is a common condition in children, easily diagnosed. Its management is varied, with varying results. The authors propose to evaluate the management of this pathology in their department and the results obtained. Method: cross-sectional study from January 2018 to December 2021 in the pediatric surgery department of CNHU-HKM. This was an exhaustive recruitment of children with prolapse during the study period. Results: 29 patients were enrolled. Mean age was 25.4 months. The predominance was female 18/11. Prolapse was total in 100% of cases, with circumferential externalization averaging 4cm in length. Average admission time was 64.8 days. Nineteen children recurred under medical treatment, representing a 65.5% failure rate. Among the children, 19 had chronic constipation and 6 had diarrhea. The 19 children who failed medical treatment underwent sclerotherapy. Two recurred. Anal cerclage was performed in 12 children, with no recurrence observed. Hospital stay was 24h. Conclusion: Despite the existence of standardized protocols, the management of rectal prolapse must be adapted to the context and the patient. The study shows the usefulness of sclerotherapy accompanied by cerclage for complete healing in cases of associated anal hollowness.