Download - RECTAL PROLAPSE: CLINICAL ASSESSMENT
![Page 1: RECTAL PROLAPSE: CLINICAL ASSESSMENT](https://reader035.vdocument.in/reader035/viewer/2022062218/5681559f550346895dc37a5d/html5/thumbnails/1.jpg)
RECTAL PROLAPSE:CLINICAL ASSESSMENT
I J AdamConsultant Colorectal Surgeon
Sheffield Teaching Hospitals NHS Trust
M62 Coloproctology Course 7th April 2005
![Page 2: RECTAL PROLAPSE: CLINICAL ASSESSMENT](https://reader035.vdocument.in/reader035/viewer/2022062218/5681559f550346895dc37a5d/html5/thumbnails/2.jpg)
CLINICAL ASSESSMENT
1. Identification of rectal prolapse
2. Pre-operative investigation of rectal prolapse
![Page 3: RECTAL PROLAPSE: CLINICAL ASSESSMENT](https://reader035.vdocument.in/reader035/viewer/2022062218/5681559f550346895dc37a5d/html5/thumbnails/3.jpg)
IDENTIFICATION OF RECTAL PROLAPSE
Clear prolapse historyNo clear prolapse historyUncertainty about what is prolapsing
![Page 4: RECTAL PROLAPSE: CLINICAL ASSESSMENT](https://reader035.vdocument.in/reader035/viewer/2022062218/5681559f550346895dc37a5d/html5/thumbnails/4.jpg)
IDENTIFICATION OF RECTAL PROLAPSE
Clear prolapse history
![Page 5: RECTAL PROLAPSE: CLINICAL ASSESSMENT](https://reader035.vdocument.in/reader035/viewer/2022062218/5681559f550346895dc37a5d/html5/thumbnails/5.jpg)
IDENTIFICATION OF RECTAL PROLAPSE
Clear prolapse history
![Page 6: RECTAL PROLAPSE: CLINICAL ASSESSMENT](https://reader035.vdocument.in/reader035/viewer/2022062218/5681559f550346895dc37a5d/html5/thumbnails/6.jpg)
IDENTIFICATION OF RECTAL PROLAPSE
Clear prolapse history
Normal examination in left lateral
![Page 7: RECTAL PROLAPSE: CLINICAL ASSESSMENT](https://reader035.vdocument.in/reader035/viewer/2022062218/5681559f550346895dc37a5d/html5/thumbnails/7.jpg)
IDENTIFICATION OF RECTAL PROLAPSE
Clear prolapse history
Normal examination in left lateral
Squat
![Page 8: RECTAL PROLAPSE: CLINICAL ASSESSMENT](https://reader035.vdocument.in/reader035/viewer/2022062218/5681559f550346895dc37a5d/html5/thumbnails/8.jpg)
IDENTIFICATION OF RECTAL PROLAPSE
Clear prolapse history
Normal examination in left lateral
SquatStrain on toilet
![Page 9: RECTAL PROLAPSE: CLINICAL ASSESSMENT](https://reader035.vdocument.in/reader035/viewer/2022062218/5681559f550346895dc37a5d/html5/thumbnails/9.jpg)
IDENTIFICATION OF RECTAL PROLAPSE
Clear prolapse history
Normal examination in left lateral
SquatStrain on toilet
![Page 10: RECTAL PROLAPSE: CLINICAL ASSESSMENT](https://reader035.vdocument.in/reader035/viewer/2022062218/5681559f550346895dc37a5d/html5/thumbnails/10.jpg)
IDENTIFICATION OF RECTAL PROLAPSE
No clear prolapse history
![Page 11: RECTAL PROLAPSE: CLINICAL ASSESSMENT](https://reader035.vdocument.in/reader035/viewer/2022062218/5681559f550346895dc37a5d/html5/thumbnails/11.jpg)
IDENTIFICATION OF RECTAL PROLAPSE
No clear prolapse history
IncontinenceDifficult evacuationBloody mucous discharge
![Page 12: RECTAL PROLAPSE: CLINICAL ASSESSMENT](https://reader035.vdocument.in/reader035/viewer/2022062218/5681559f550346895dc37a5d/html5/thumbnails/12.jpg)
IDENTIFICATION OF RECTAL PROLAPSE
No clear prolapse history
Incontinence
![Page 13: RECTAL PROLAPSE: CLINICAL ASSESSMENT](https://reader035.vdocument.in/reader035/viewer/2022062218/5681559f550346895dc37a5d/html5/thumbnails/13.jpg)
IDENTIFICATION OF RECTAL PROLAPSE
No clear prolapse history
Incontinence
![Page 14: RECTAL PROLAPSE: CLINICAL ASSESSMENT](https://reader035.vdocument.in/reader035/viewer/2022062218/5681559f550346895dc37a5d/html5/thumbnails/14.jpg)
IDENTIFICATION OF RECTAL PROLAPSE
No clear prolapse history
Incontinence
![Page 15: RECTAL PROLAPSE: CLINICAL ASSESSMENT](https://reader035.vdocument.in/reader035/viewer/2022062218/5681559f550346895dc37a5d/html5/thumbnails/15.jpg)
IDENTIFICATION OF RECTAL PROLAPSE
No clear prolapse history
Difficult evacuation
![Page 16: RECTAL PROLAPSE: CLINICAL ASSESSMENT](https://reader035.vdocument.in/reader035/viewer/2022062218/5681559f550346895dc37a5d/html5/thumbnails/16.jpg)
IDENTIFICATION OF RECTAL PROLAPSE
No clear prolapse history
Bloody mucous discharge
![Page 17: RECTAL PROLAPSE: CLINICAL ASSESSMENT](https://reader035.vdocument.in/reader035/viewer/2022062218/5681559f550346895dc37a5d/html5/thumbnails/17.jpg)
IDENTIFICATION OF RECTAL PROLAPSE
Uncertainty about what is prolapsing
![Page 18: RECTAL PROLAPSE: CLINICAL ASSESSMENT](https://reader035.vdocument.in/reader035/viewer/2022062218/5681559f550346895dc37a5d/html5/thumbnails/18.jpg)
IDENTIFICATION OF RECTAL PROLAPSE
Uncertainty about what is prolapsing
Circumferential mucosal prolapse
![Page 19: RECTAL PROLAPSE: CLINICAL ASSESSMENT](https://reader035.vdocument.in/reader035/viewer/2022062218/5681559f550346895dc37a5d/html5/thumbnails/19.jpg)
IDENTIFICATION OF RECTAL PROLAPSE
Uncertainty about what is prolapsing
Circumferential mucosal prolapse
![Page 20: RECTAL PROLAPSE: CLINICAL ASSESSMENT](https://reader035.vdocument.in/reader035/viewer/2022062218/5681559f550346895dc37a5d/html5/thumbnails/20.jpg)
IDENTIFICATION OF RECTAL PROLAPSE
Uncertainty about what is prolapsing
Circumferential mucosal prolapse
![Page 21: RECTAL PROLAPSE: CLINICAL ASSESSMENT](https://reader035.vdocument.in/reader035/viewer/2022062218/5681559f550346895dc37a5d/html5/thumbnails/21.jpg)
CLINICAL ASSESSMENT
1. Identification of rectal prolapse
2. Pre-operative investigation of rectal prolapse
![Page 22: RECTAL PROLAPSE: CLINICAL ASSESSMENT](https://reader035.vdocument.in/reader035/viewer/2022062218/5681559f550346895dc37a5d/html5/thumbnails/22.jpg)
PRE-OPERATIVE INVESTIGATION OF RECTAL PROLAPSE PATIENTS
Sigmoidoscopy
![Page 23: RECTAL PROLAPSE: CLINICAL ASSESSMENT](https://reader035.vdocument.in/reader035/viewer/2022062218/5681559f550346895dc37a5d/html5/thumbnails/23.jpg)
PRE-OPERATIVE INVESTIGATION OF RECTAL PROLAPSE PATIENTS
Sigmoidoscopy rectal neoplasmssolitary rectal ulcermucosal inflammation
![Page 24: RECTAL PROLAPSE: CLINICAL ASSESSMENT](https://reader035.vdocument.in/reader035/viewer/2022062218/5681559f550346895dc37a5d/html5/thumbnails/24.jpg)
PRE-OPERATIVE INVESTIGATION OF RECTAL PROLAPSE PATIENTS
Is a sigmoidoscopy enough?
![Page 25: RECTAL PROLAPSE: CLINICAL ASSESSMENT](https://reader035.vdocument.in/reader035/viewer/2022062218/5681559f550346895dc37a5d/html5/thumbnails/25.jpg)
PRE-OPERATIVE INVESTIGATION OF RECTAL PROLAPSE PATIENTS
Is a sigmoidoscopy enough?
Controversial area
Straight to theatreInvestigate all patients
![Page 26: RECTAL PROLAPSE: CLINICAL ASSESSMENT](https://reader035.vdocument.in/reader035/viewer/2022062218/5681559f550346895dc37a5d/html5/thumbnails/26.jpg)
PRE-OPERATIVE INVESTIGATION OF RECTAL PROLAPSE PATIENTS
Denis, Ganansia & Puy-MontbrunProctologie Pratique
Selective investigations based on clinical features
![Page 27: RECTAL PROLAPSE: CLINICAL ASSESSMENT](https://reader035.vdocument.in/reader035/viewer/2022062218/5681559f550346895dc37a5d/html5/thumbnails/27.jpg)
PRE-OPERATIVE INVESTIGATION OF RECTAL PROLAPSE PATIENTS
ConstipationDiarrhoeaIncontinence
![Page 28: RECTAL PROLAPSE: CLINICAL ASSESSMENT](https://reader035.vdocument.in/reader035/viewer/2022062218/5681559f550346895dc37a5d/html5/thumbnails/28.jpg)
PRE-OPERATIVE INVESTIGATION OF RECTAL PROLAPSE PATIENTS
Constipation
![Page 29: RECTAL PROLAPSE: CLINICAL ASSESSMENT](https://reader035.vdocument.in/reader035/viewer/2022062218/5681559f550346895dc37a5d/html5/thumbnails/29.jpg)
PRE-OPERATIVE INVESTIGATION OF RECTAL PROLAPSE PATIENTS
Constipation
Slow Transit Constipation
![Page 30: RECTAL PROLAPSE: CLINICAL ASSESSMENT](https://reader035.vdocument.in/reader035/viewer/2022062218/5681559f550346895dc37a5d/html5/thumbnails/30.jpg)
PRE-OPERATIVE INVESTIGATION OF RECTAL PROLAPSE PATIENTS
Diarrhoea
![Page 31: RECTAL PROLAPSE: CLINICAL ASSESSMENT](https://reader035.vdocument.in/reader035/viewer/2022062218/5681559f550346895dc37a5d/html5/thumbnails/31.jpg)
PRE-OPERATIVE INVESTIGATION OF RECTAL PROLAPSE PATIENTS
Diarrhoea
Infection
![Page 32: RECTAL PROLAPSE: CLINICAL ASSESSMENT](https://reader035.vdocument.in/reader035/viewer/2022062218/5681559f550346895dc37a5d/html5/thumbnails/32.jpg)
PRE-OPERATIVE INVESTIGATION OF RECTAL PROLAPSE PATIENTS
Diarrhoea
Bowel investigations
![Page 33: RECTAL PROLAPSE: CLINICAL ASSESSMENT](https://reader035.vdocument.in/reader035/viewer/2022062218/5681559f550346895dc37a5d/html5/thumbnails/33.jpg)
PRE-OPERATIVE INVESTIGATION OF RECTAL PROLAPSE PATIENTS
Incontinence
![Page 34: RECTAL PROLAPSE: CLINICAL ASSESSMENT](https://reader035.vdocument.in/reader035/viewer/2022062218/5681559f550346895dc37a5d/html5/thumbnails/34.jpg)
PRE-OPERATIVE INVESTIGATION OF RECTAL PROLAPSE PATIENTS
Incontinence
![Page 35: RECTAL PROLAPSE: CLINICAL ASSESSMENT](https://reader035.vdocument.in/reader035/viewer/2022062218/5681559f550346895dc37a5d/html5/thumbnails/35.jpg)
PRE-OPERATIVE INVESTIGATION OF RECTAL PROLAPSE PATIENTS
Incontinence
Selective approach young patientsincontinence an issue
![Page 36: RECTAL PROLAPSE: CLINICAL ASSESSMENT](https://reader035.vdocument.in/reader035/viewer/2022062218/5681559f550346895dc37a5d/html5/thumbnails/36.jpg)
SUMMARYCLINICAL ASSESSMENT OF RECTAL PROLAPSE
![Page 37: RECTAL PROLAPSE: CLINICAL ASSESSMENT](https://reader035.vdocument.in/reader035/viewer/2022062218/5681559f550346895dc37a5d/html5/thumbnails/37.jpg)
SUMMARYCLINICAL ASSESSMENT OF RECTAL PROLAPSE
Identification of rectal prolapsePre-operative investigation of rectal prolapse
![Page 38: RECTAL PROLAPSE: CLINICAL ASSESSMENT](https://reader035.vdocument.in/reader035/viewer/2022062218/5681559f550346895dc37a5d/html5/thumbnails/38.jpg)
SUMMARYCLINICAL ASSESSMENT OF RECTAL PROLAPSE
Identification of rectal prolapse
Examination during squat or on toilet
Defaecating proctogramRectal biopsy
![Page 39: RECTAL PROLAPSE: CLINICAL ASSESSMENT](https://reader035.vdocument.in/reader035/viewer/2022062218/5681559f550346895dc37a5d/html5/thumbnails/39.jpg)
SUMMARYCLINICAL ASSESSMENT OF RECTAL PROLAPSE
Pre-operative investigation of rectal prolapse
Sigmoidoscopy for all patients
Slow transit constipationDiarrhoea
Younger patients with incontinence