Rectal mass with or without ulceration or necrosis.
Tenesmus.
Pain .
Client history
Rectal mass with or without ulceration or necrosis.
Tenesmus.
Pain.
Clinical signs
Rectal tissue is everted.
Inability to pass lubricated probe between rectal wall and prolapsed mass - rules out intussusception.
Confirmation of diagnosis Discriminatory Diagnostic features
History.
Definitive Diagnostic features
Clinical signs.
Gross autopsy findings
Affected segment must be checked carefully for predisposing lesions, including neoplasia, other masses, inflammation and parasitism.
Affected segment is typically congested, edematous, with thickened mucosa.
Check for causes of straining, including examination of pelvic cavity - requires removal or ventral pelvic bones by cutting cranially and caudally from each obturator foramen.
Note that colon or rectal adenocarcinomas may resemble ulcers and strictures rather than a neoplastic mass.
Histopathology findings
Vascular congestion and mucosal edema are typical.
Histopathology required to rule out colonic or rectal adenocarcinoma, or other infiltrative neoplasia.
A warm isotonic solution is applied to the exposed mucosa. The mucosa is gently manipulated and massaged to attempt the removal of edema from the prolapsed segment.
The prolapse is then gently reduced following the application of a water-soluble lubricant to its surface.
A loose purse-string suture is placed in the anus; the suture should be removed in 7-10 days .
Fecal softener.
Dietary modification.
Surgery :
Colopexy, if conservative management fails.
Amputation of prolapsed rectum, if on initial presentation the rectal mucosa is necrotic, lacerated or irreducible.
