Solitary rectal ulcer syndrome: A case series

Suresh, N.; Ganesh, Ramaswamy; Sathiyasekaran, Malathi

doi:10.1007/s13312-010-0177-0

Cited by 28 publications

(40 citation statements)

References 6 publications

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“…SRUS is a benign rectal disorder of defaecation which is a well-recognized entity in adults but often misdiagnosed or underdiagnosed in children [1,3,[5][6][7][8] . In the literature there are only few case reports, and the largest paediatric series included 22 cases [8] .…”

Section: Discussionmentioning

confidence: 99%

“…In the literature there are only few case reports, and the largest paediatric series included 22 cases [8] . The youngest reported patient with SRUS was a 1.5-year-old child [5,8] , but the majority of cases are children older than 8 years.…”

Section: Discussionmentioning

confidence: 99%

“…Surgical treatments include rectal prolapse correction, ulcer excision, and, rarely, colostomy [2,5] . In paediatric patients rectopexy seems to be effective in cases in which rectal prolapse is implicated [3,8,16,17] . Resection proctectomy may be reserved for patients with intractable rectal pain and bleeding who do not respond to other surgical treatments [2] .…”

Section: Discussionmentioning

confidence: 99%

“…The excessive straining generates a high intrarectal pressure which pushes the anterior rectal mucosa into the contracting puborectalis muscle, resulting in pressure necrosis of the rectal mucosa. The anterior rectal mucosa is frequently forced into the closed anal canal, causing congestion, oedema, and ulceration [5,7,8] .…”

Section: Introductionmentioning

confidence: 99%

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Solitary Rectal Ulcer Syndrome: A Paediatric Case Report

Abreu¹,

Alves²,

Pinto

et al. 2017

GE Port J Gastroenterol

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Síndrome da Úlcera Retal Solitária: Relato de um Caso PediátricoPalavras Chave Criança · Doenças do recto · Hemorragia gastrointestinal · Síndrome · Úlcera Resumo Introdução: O Síndrome da Úlcera Retal Solitária (SRUS) é uma doença benigna incomum que afeta predominantemente jovens adultos, sendo rara na população pediátri-ca. Caso Clínico: Rapariga de 12 anos com história de 6 meses de evolução de tenesmo, aumento da frequência defecatória e retorragias com muco. Sem antecedentes de obstipação ou outras queixas. Na observação inicial, o exame físico e o estudo analítico eram normais. O exame bacteriológico e virológico das fezes foi negativo. A colonoscopia realizada revelou uma úlcera única no reto distal, a 6 cm da margem anal. As biópsias confirmaram o diagnóstico de SRUS. Apesar do tratamento conservador, os sintomas persistiram. A defecografia mostrou um pequeno retocelo, sem prolapso da mucosa. Devido à proximidade com o esfíncter anal, não foi efectuado tratamen- KeywordsChild · Gastrointestinal haemorrhage · Rectal diseases · Syndrome · Ulcer Abstract Introduction: Solitary rectal ulcer syndrome (SRUS) is an uncommon benign rectal disease. Mostly young adults are affected, and it is rare in paediatric populations. Clinical Case: We present a 12-year-old girl with a 6-month history of tenesmus, frequent defaecation, and bloody stools with mucus. There was no previous history of constipation or other symptoms. At the first visit, physical examination and routine laboratory test results were normal. A stool examination for bacteria and parasites was negative. Colonoscopy revealed a single ulcer in the distal rectum 6 cm from the anal margin. SRUS was confirmed by biopsy. Despite conservative measures, the symptoms persisted. A defaecation proctography showed a small rectocele with no rectal mucosal prolapse. Because of its proximity to the anal sphincter, no surgical intervention was performed. Conclusion: The present case illustrates how difficult the management of SRUS is. Multicentre studies are needed to establish treatment protocols for children. to cirúrgico. Conclusão: O presente caso ilustra o quão difícil é a abordagem do SRUS. São necessários estudos multicêntricos para estabelecer protocolos de tratamento na idade pediátrica.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Solitary Rectal Ulcer Syndrome: A Paediatric Case Report

Abreu¹,

Alves²,

Pinto

et al. 2017

GE Port J Gastroenterol

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“…It seems that the occurrence of SRU is part of the evolution from polypoid to ulcerative lesions in patients with rectal prolapse (19). According to previous case reports and case series, ulcers and polyps have been the most common endoscopic findings in more than 90% of patients with SRU (34)(35)(36)(37)(38).…”

Section: Colonoscopic Findingsmentioning

confidence: 99%

Solitary Rectal Ulcer: A Literature Review

2015

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Context: Solitary rectal ulcer (SRU) is a disease with many challenging issues. There are several controversies about the basic pathophysiology of this disease. Despite its name, "solitary rectal ulcer", more than a quarter of patients do not show any ulcer in colonoscopy. Instead, many patients show multiple polypoid lesions. Some previous reports have suggested calling this disease "rectal mucosal prolapse" instead of SRU, however, most of the patients do not have mucosal prolapse. In addition, colonoscopic findings can be very similar to cancer and inflammatory bowel disease, so without histologic evaluation, accurate diagnosis is not always possible. In patients with SRU, sometimes the rectal mucosa is so fibrotic that mucosal biopsy is inadequate, and even a pathologist cannot diagnose the characteristic histologic findings. There are various therapeutic approaches for the treatment of SRU, both surgical and nonsurgical, all of which are not optimal, and recurrence rates are still high with many patients experiencing complications even after surgery, resection and rectopexy. Evidence Acquisition: Although this disease is not uncommon in Iran, there are very few studies from Iran, therefore, in this review we will describe our experience with patients with SRU in affiliated hospitals of Shiraz University of Medical Sciences. We will also review previously published articles about SRU that are indexed in PubMed and Google scholar, emphasizing the challenging issues. Results: SRU is not an uncommon disease in Iran, however the number of published articles about it, is very low. Multicentric studies are necessary to find out the definite reason of this issue. Conclusions: There are still many conflicting controversies about the etiology, pathogenesis, diagnosis and also treatment of SRU, which need further investigation and longer follow up of the patient in each therapeutic approach to be better understood.

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