Rectal Prolapse: A New Clinical Sign

Abstract Background: Rectal prolapse is a rare condition with many morbidities. Rectal prolapse is diagnosed on history, making the patient squat, strain, and let the rectum prolapse. No clinical sign has been described for suspecting the condition in the patient presenting to the hospital without the presence of rectal prolapse. Mohan’s sign is a clinical sign that can help suspect rectal prolapse during Per Rectal examination. Patients and Methods: Patients who presented with complaints of mass per rectum during defecation was subjected to Per Rectal and Proctoscopy. The findings of the examinations were recorded, and all the patients were subjected to straining while squatting. The findings were then compared with those of the per rectal examination. Results: In this study, 38 patients were included, out of which 08 cases had rectal prolapse, 09 cases had mucosal prolapse, and 21 cases had hemorrhoids. Ten patients were positive for Mohan’s sign, and 28 patients were negative for Mohan’s sign. This sign was 87% sensitive and 90% specific. The positive predictive value for this sign was 70%, and the negative predictive value was 96%. Conclusion: Mohan’s is an excellent clinical sign with a high accuracy rate for suspecting rectal prolapse during Per Rectal examination and can help the surgeon select a patient, to be subjected to straining while squatting. This will help the surgeon avoid the embarrassing and at times arduous examination in the squatting position.