[Rectal prolapse in a 3-year-8-month-old child].

Arch Pediatr

Clinique médicale pédiatrique, hôpital mère-enfant, 7, quai Moncousu, 44093 Nantes cedex 1, France.

Published: September 2008

Introduction: Starting from a recent clinical case, we present the different causes of rectal prolapse and their specific treatments. In this case, the relation to infectious colitis was questionable.

Observation: This 3-year-8-month-old boy had repetitive rectal prolapses with phlegmy and bloody diarrhea, with reduction increasingly difficult. Stool analysis was negative but pseudomembranous colitis was found with coloscopy and was confirmed by biopsy.

Discussion: Hygienic and dietary measures are the first steps in the treatment rectal prolapse. Pseudomembranous colitis, often related to Clostridium difficile toxins; is a severe form of postantibiotic diarrhea. Its treatment is based on oral antibiotic therapy with metronidazole or vancomycin for 10 days. Rectal prolapsus in children is cured without recurrence in 98% of cases.

Conclusion: In the case reported herein, rectal prolapse did not recur after diarrhea recovery with antibiotic therapy, suggesting a causative link with pseudomembranous colitis.

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http://dx.doi.org/10.1016/j.arcped.2008.06.015DOI Listing

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