A 50-year-old truck driver comes to your clinic for a work physical. [rectal prolapse]
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Answer:
The 50-year-old truck driver most likely has a rectal prolapse. This is a condition where the rectum falls down into the anal canal. The rectum is the last part of the large intestine, and the anal canal is the last part of the rectum. The anal canal is about 2-3 inches long. The rectum prolapses when the rectum becomes too weak to hold up the weight of the intestine. The prolapse may be partial or complete. In this truck driver’s case, it is most likely a partial prolapse.
Question:
A 50-year-old truck driver comes to your clinic for a work physical. He has had no upper respiratory, cardiac, pulmonary, gastrointestinal, urinary, or musculoskeletal system complaints. His past medical history is significant for mild arthritis and prior knee surgery in college. He is married and just changed jobs, working for a different trucking company. He smokes one pack of cigarettes a day, drinks less than six beers a week, and denies using any illegal drugs. His mother has high blood pressure and arthritis and his father died of lung cancer in his sixties. On examination, his blood pressure is 130/80 and his pulse is 80. His cardiac, lung, and abdominal examinations are normal. He has no inguinal hernia, but on his digital rectal examination you palpate a soft, smooth, and nontender pedunculated mass on the posterior wall of the rectum. What anal, rectal, or prostate disorder best fits his presentation?
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