Clinical Presentation of Partial Rectal Mucosal Prolapse and Its Outcome Following Submucosal Injection of 50% Dextrose Water

Abstract

The study investigated the clinical presentation and proctoscopic findings of anterior rectal mucosal prolapsed (ARMP) and to evaluate the effect of submucosal injection of 50% dextrose water( DW) as a sclerosing agent. All the cases which were diagnosed as anterior rectal mucosal prolapsed and treated by submucosal injection of 50% dextrose water during the period of 10 years were prospectively studied. The included cases were studied with regard to age, sex, symptoms and signs of presentation and the findings of proctoscopic examination and the number of medical consultations prior to final diagnosis. The patients were followed up to 18 months. The response of the patients was evaluated, and the number of injection settings for each case, complications, recurrences.28 cases of ARMP, 24(85.71%) males, 4 (14,28%) females, age range 4-45 years. Among the symptoms of presentation, the most frequent were a bulging perimass 53%, straining at stool and delay in lavatory 50 %.The findings on proctoscopy; prolapsed anterior rectal mucosa 100%,anterior rectal ulcers 42.85% .Sclerotherapy was successful in 96.5%.24 patients improved after one session,3 cases required two sessions to improve while 1 case failed (P value < 0.001).We can conclude that ARMP affects all ages. The patients commonly present with obstructive defecation rectal bleeding associated with perianal bulging. sclerotherapy using 50% DW is simple and safe and effective procedure for ARMP.