Ultra-Low Anterior Resection with Coloanal Anastomosis for Recurrent Rectal Prolapse in a Young Woman with Colitis Cystica Profunda

Abstract

This case demonstrates the successful treatment of a young female patient with colitis cystica profunda causing rectal prolapse, after primary treatment with a Delorme procedure had failed. An ultra-low anterior resection with a temporary defunctioning ileostomy was carried out with good postoperative results. This case illustrates the possibility of carrying out sphincter preserving surgery rather than an abdominoperineal resection in the treatment of this condition, which may be preferable for patients.

Colitis cystica profunda: A report of two cases

“…The local type is mostly seen in the anterior wall of the rectal 5–12 cm from the anal verge, presenting as nodules or polyps, which is associated with rectal prolapse and isolated rectal ulcer syndrome. The local type is the most common, while the diffuse type accounting for less than 15% of cases reported in the literature 1,3,13,14 . Both cases in this paper were young and middle‐aged patients with clinical characteristics of mucous excretion.…”

Report of a case combining solitary Peutz-Jeghers polyp, colitis cystica profunda, and high-grade dysplasia of the epithelium of the colon

“…Frequent and well known symptoms of CCP incorporate hematochezia, mucus secretion in feces, rectal tenesmus, altered bowel habits, and obstructive defecation. Intestinal obstruction such as in our case is rare [ 1 , 4 , 5 ]. Barium studies may show normal or nonspecific signs and features in the early stages or reveal narrowing of the lumen.…”

“…CCP may demonstrate itself in a focalized form or in a more disseminated pattern, with variable length of the wall of the bowel affected. The former type has been associated with diseases like solitary rectal ulcer syndrome, prolapse of the rectum, while the latter involves patients with inflammatory bowel disease, infectious, and radiation colitis [ 1 , 5 , 6 ].…”

“…Its etiology is not fully elucidated with many authors proposing ischemic, inflammatory, and post-traumatic mechanisms of development [ 4 ]. In 1957, Goodall and Sinclair published the first modern description in the English medical literature of this benign condition, a disease first described by Stark in 1766, who found these lesions in after death examinations of cases of dysentery [ 1 , 5 , 6 ]. The term “colitis cystica profunda” was presented later on in 1863 by Virchow, accompanying an article describing multiple polypoid cystic submucosal lesions [ 6 , 7 ].…”

Colitis cystica profunda: a two-patient case series

“…The local type is mostly seen in the anterior wall of the rectal 5-12 cm from the anal verge, presenting as nodules or polyps, which is associated with rectal prolapse and isolated rectal ulcer syndrome. The local type is the most common, while the diffuse type accounts for less than 15% of cases reported in the literature [1,3,13,14] . Both of the two cases in this paper were young and middle-aged patients with clinical characteristics of mucous excretion.…”