Thesis (Ph.D)-Cairo University, 2024.

Bibliography: pages 83-94.

Introduction:
Idiopathic rectal prolapse is a relatively common self-limiting condition in infants and
children. When conservative management fails, often sclerotherapy or surgical intervention is
recommended. Injection 15% hypertonic saline is one of the safe, cost effective and technically
readily available sclerosants.



Objective:
To describe outcome of sclerotherapy with 15% hypertonic saline in patients with
idiopathic partial rectal prolapse.
Setting:
Specialized Pediatric Hospital (CUSPH), Cairo university, Cairo , Egypt .
Materials and Methods:
We enrolled 40 patients with idiopathic partial rectal prolapse, in whom conservative
management failed, including 24 males and 16 females (M: F 1:0.6). Th is study carried out for
12 months from January 2023 till January 2024. The mean duration of rectal prolapse was 14.4 ±
4.04 months. Under GA 15% hypertonic saline was injected submucosally at 4 anal quadrants
avoiding anterior anal aspects owing to proximity with urethra or vagina. Up to two sessions
were given where required and results analyzed through SPSS 21.
Results:
In 95% of patients’ resolution of prolapse occurred with single session of sclerotherapy.
In 5% rectal prolapse resolved with two sessions of sclerotherapy. Two patients developed
perianal abscess which resolved with conservative management. There was no recurrence in any
patient on follow-up of at least 6 months.
Conclusion:
Injection 15% hypertonic saline is safe, easy to inject, cost effective sclerosing agent
which could be prepared in hospital pharmacy. We found 100% success rate with up to two
sessions of injections. Injection 15% hypertonic saline can be safely chosen as the sclerosing
agent for idiopathic rectal prolapse in children.

Issues also as CD.

Text in English and abstract in Arabic & English.