[size=20px]A 3-year-old boy has partial-thickness rectal prolapse intermittently for the last 6 months. His parents need to manually reduce it every other week. He passes a hard stool every 2 to 3 days. There is no history of greasy stools or failure to thrive. The most appropriate next step is:

 

A Sweat chloride test

 

B Pelvic floor therapy

 

C Laxative therapy

 

D Laparoscopic rectopexy

 

E Sclerotherapy[/size]

C

C

C

C

c

C

Sclerotherapy

C: laxative

C

C

C

as it is the most precipitating factor

C

correct answer

C Laxative therapy

 

This is a young child with constipation who has an uncomplicated, partial-thickness prolapse involving rectal mucosa only. Rectal prolapse generally resolves with the management of constipation, which is the most frequent cause in young children. Pelvic floor therapy is not feasible in an uncooperative toddler. Screening for cystic fibrosis with a sweat chloride is unlikely to be fruitful in the absence of voluminous stools or other manifestations of this disease. Sclerotherapy can be considered in patients who fail medical therapy or experience complications, such as bleeding. Laparoscopic rectopexy is generally reserved for full-thickness rectal prolapse in older children.