Changes

==Introduction==

==Introduction==

Rectal prolapses occur when the '''pressure gradient between the pelvic and abdominal cavities is increased''' causing the rectal mucosa to bulge and protrude through its sphincter.  

Rectal prolapses occur when the '''pressure gradient between the pelvic and abdominal cavities is increased''' causing the rectal mucosa to bulge and protrude through its sphincter.  

There are four categories of prolapses described:

There are four categories of prolapses described:

1)'''Mucosal''' prolapse

1) '''Mucosal''' prolapse

2)'''Complete''' prolapse

2) '''Complete''' prolapse

3)'''Complete prolapse with invagination of colon'''

3) '''Complete prolapse with invagination of colon'''

4)'''Intususception of rectum or colon''' through the anus

4) '''[[Intussusception]] of rectum or colon''' through the anus

==Distribution==

==Distribution==

==Signalment==

==Signalment==

'''Predisposing factors are any that cause tenesmus or diarrhoea''', such as enteritis, colitis, parasitism, dystocia, obesity, urethral obstruction or cystitis/urolithiasis, '''respiratory disease causing prolonged coughing and also increased abdominal fill''' in high fecundity ewes or cases of [[Bloat|bloat]].  

'''Predisposing factors are any that cause tenesmus or [[Diarrhoea|diarrhoea]]''', such as [[Enteritis|enteritis]], colitis, parasitism, [[Dystocia|dystocia]], obesity, urethral obstruction or cystitis/[[Urolithiasis|urolithiasis]], '''respiratory disease causing prolonged coughing and also increased abdominal fill''' in high fecundity ewes or cases of [[Bloat|bloat]].  

This condition also occurs in cattle.

This condition also occurs in cattle.

'''Clinical examination''' is usually sufficient to diagnose and stage a rectal prolapse.  

'''Clinical examination''' is usually sufficient to diagnose and stage a rectal prolapse.  

A prolapse must be '''differentiated from an ileocolic intususception''' by passing a proble, blunt instrument or finger between the prolapsed mass and the rectal wall. The fornix of the rectal wall in a prolapse would prevent insertion beyond a couple of centimetres.

A prolapse must be '''differentiated from an ileocolic [[Intussusception|intussusception]]''' by passing a probe, blunt instrument or finger between the prolapsed mass and the rectal wall. The fornix of the rectal wall in a prolapse would prevent insertion beyond a couple of centimetres.

==Treatment==

==Treatment==

An '''epidural''' should be administered and the '''prolapse cleaned with warm water and soap''' and then '''evaluated for viability and necrosis'''. Any necrotic areas should be '''surgically debrided/amputated''' using the appropriate procedure and wounds sutured closed. It should then be '''replaced manually with plenty of lubricant'''. Circumferential '''purse string sutures''' can be placed to prevent recurrence although care must be taken not to occlude faecal passage. These are removed in 3-4 days.  

An '''[[Epidural|epidural]]''' should be administered and the '''prolapse cleaned with warm water and soap''' and then '''evaluated for viability and necrosis'''. Any necrotic areas should be '''surgically debrided/amputated''' using the appropriate procedure and wounds sutured closed. It should then be '''replaced manually with plenty of lubricant'''. Circumferential '''purse string sutures''' can be placed to prevent recurrence although care must be taken not to occlude faecal passage. These are removed in 3-4 days.  

The '''predisposing factors should be identified and rectified''' to prevent further cases.  

The '''predisposing factors should be identified and rectified''' to prevent further cases.  

{{Learning

{{Learning

|flashcards = [[Ovine rectal prolapses Flashcards]]

|flashcards = [[Ovine rectal prolapses Flashcards]]

}}

}}

Merck Veterinary Manual, '''Rectal prolapse''', accessed online 24/07/2011 at http://www.merckvetmanual.com/mvm/index.jsp?cfile=htm/bc/20609.htm&word=rectal%2cprolapse

Merck Veterinary Manual, '''Rectal prolapse''', accessed online 24/07/2011 at http://www.merckvetmanual.com/mvm/index.jsp?cfile=htm/bc/20609.htm&word=rectal%2cprolapse

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