Treatment and prognosis of rectal prolapse in cystic fibrosis

15-Year experience in the treatment of rectal prolapse in children

“…In this country, constipation is the most common association. Cystic fibrosis (CF) is associated with nearly a 20% incidence of prolapse in some reports, but most children with prolapse do not have undiagnosed CF, particularly in the absence of symptoms [6,7]. None of the children in our series had CF.…”

Management of Rectal Prolapse in Children

“…26 In our study, of 16 cases that had a cystic fibrosis screen, a positive result was found in only one patient (6 percent). Some authors recommend a sweat test for all cases of rectal prolapse 24,25 ; however, we think that this should be reserved for cases that have no underlying diagnosis and have recurrent rectal prolapse refractory to conservative treatment. Rectal prolapse has been shown to occur more frequently in neurologically impaired children, most cases requiring surgical intervention.…”

“…In our series, 49 percent of patients required an operation, which is within the range of other series in which 9 to 70 percent of children underwent surgical intervention. 1,25,28 However, because this was a retrospective study, it is not known whether rectal prolapse in these patients would have resolved spontaneously without any further interventions, as seen in four patients who were treated conservatively. The decision about when to operate is usually a difficult one.…”

“…25 In children with cystic fibrosis, the prolapse often is recurrent and is probably related to malnutrition, poor muscle tone, and passage of voluminous stools. 26 In our study, of 16 cases that had a cystic fibrosis screen, a positive result was found in only one patient (6 percent).…”

Hemoptysis in Israeli CF patients — Prevalence, treatment, and clinical characteristics

“…Treatment included antibiotics, tranexamic acid, and vitamin K. Of note, vitamin K was administered even when coagulation tests were normal, assuming that vitamin K deficiency can exist even in the presence of normal PT and PTT [1,20]. Bleeding in our patients stopped after a maximum of 7 days under conservative therapy.…”