„Rectal-Pocket-Syndrom“ nach Stapler-Hämorrhoidopexie

Abstract

We report the case of a 41-year-old female patient who presented in the emergency department with recurrent pain in the lower abdomen 3 years after haemorrhoidopexy (Longo's procedure). At clinical examination a space-occupying mass between the rectum and the vagina was present which was identified as a stool-loaded diverticulum of the rectum by magnetic resonance imaging. Using a perineal approach the diverticulum could be excised at its base and the defect of the mucosa was closed transanally with sutures. A diverticulum of the rectum is a rare complication (2.5%) after stapled haemorrhoidopexy. In the diagnostic of complications after Longo's haemorroidopexy the MRI constitutes an excellent auxiliary modality.

Combined endoscopic–laparoscopic treatment of a rectal pocket syndrome after sigmoid resection

“…However, there might be a considerably higher incidence of rectal pocket syndrome after PPH because of a manually performed purse-string suture which is probably rather prone to fail. The rectal pocket syndrome may become symptomatic few months after surgery [3]; however, the interval between the index surgery and the occurrence of symptoms could extend beyond 3-10 years [6], as in the current case. Therefore, physicians should be aware of rectal pocket syndrome in patients with new-onset defecatory disorders and a history of previous bowel resection with a circular stapled anastomosis.…”

A systematic review of the literature assessing the outcomes of stapled haemorrhoidopexy versus open haemorrhoidectomy

“…These occurrences show that the potential for postoperative morbidity is not exclusive to SH. Nonetheless, one must be vigilant in recognizing rare complications such as rectal pocket syndrome [55], rectocoele and rectal intussusception [56] so as to prevent severe pelvic or intra-abdominal sepsis.…”