Solitary Rectal Ulcer Syndrome: Case Report of Two Patients from a Tertiary Care Centre in Manipur, North-East India.
Journal Title: IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) - Year 2018, Vol 17, Issue 11
Abstract
Solitary rectal ulcer syndrome (SRUS) is an uncommon benign disorder of defecation. The mechanisms of this condition are poorly understood. SRUS forms a component of the spectrum of benign defecation disorders comprising rectal prolapse, proctitis cystica profunda (PCP) and inflammatory polyps. Complications of SRUS include rectal prolapse, intussusception etc. However, malignancy has not been reported following SRUS. The most accepted etiopathogenic mechanism of SRUS is chronic hypoperfusion induced ischemic injury to rectal mucosa. Definitive treatment of SRUS is still unclear varying from conservative management to surgical procedures such as rectopexy or resection and anastomosis. Here we are reporting cases of two young females admitted in the surgical ward of RIMS Imphal presented with complaints of recurrent bleeding per rectum. On examination patients vitals were stable. Pallor was noted. Digital rectal examination and proctoscopy findings were within normal limits. On further evaluation with colonoscopy, solitary rectal ulcer was noted in both patients. Initially ulcer was managed conservatively using stool softeners, bland diet, iron supplements and enema. But symptoms did not subside by conservative methods. Se we planned for surgical intervention in the form of localised anterior resection of rectum and anastomosis using stapler technique. During the post-operative and follow up period patients improved symptomatically. Hence, we are suggesting that localised anterior resection of rectum with primary anastomosis using single or double stapler technique is a good treatment option for SRUS when conservative management fails.
Authors and Affiliations
Dr. Sreejith V, Dr. Resen Rajan S Methikkalam, Dr. Christo Cyriac Thomas, Dr. Digbijoy Krishna Debbarma, Dr. Angela B Marak, Prof. G S Moirangthem
Keywords
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