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Case ReportOpen Access
Solitary Rectal Ulcer Syndrome : Two Case Reports
Akaraviputh T 
,
Watanapa P ,
Ratanarapee S
,
Watanapa P ,
Ratanarapee S Owing to its rarity, solitary rectal ulcer syndrome (SRUS) is often misdiagnosed as malignant
ulcer, or ulcer in association with inflammatory bowel disease. We present two adult females
with anorectal symptoms (i.e. pain, tenesmus and bowel habit changes). Both had normal levels of
serum carcinoembryonic antigen. Barium enema revealed irregular mucosa with stricture of the
lower rectum. An ulcer, 2.7 em in diameter, was found in one patient but not the other. Rectal biopsy
under sigmoidoscopy demonstrated non-specific inflammation, without evidence of malignancy.
Because of the intractable symptoms and the inability to discriminate between malignant and benign
conditions, exploratory laparotomy was performed, followed by low anterior resection of the
rectum. Histological examination of both specimens showed submucosal rectal fibrosis with a
non-specific ulceration in one. These findings were compatible with SRUS. The patients' symptoms
improved dramatically after the resection and they remain well, five months and one year
after surgery. Awareness of this rare anorectal condition is necessary for appropriate management
particularly to avoid unnecessary abdomino-perineal resection.
Key word : Solitary Rectal Ulcer Syndrome, Case Report
ulcer, or ulcer in association with inflammatory bowel disease. We present two adult females
with anorectal symptoms (i.e. pain, tenesmus and bowel habit changes). Both had normal levels of
serum carcinoembryonic antigen. Barium enema revealed irregular mucosa with stricture of the
lower rectum. An ulcer, 2.7 em in diameter, was found in one patient but not the other. Rectal biopsy
under sigmoidoscopy demonstrated non-specific inflammation, without evidence of malignancy.
Because of the intractable symptoms and the inability to discriminate between malignant and benign
conditions, exploratory laparotomy was performed, followed by low anterior resection of the
rectum. Histological examination of both specimens showed submucosal rectal fibrosis with a
non-specific ulceration in one. These findings were compatible with SRUS. The patients' symptoms
improved dramatically after the resection and they remain well, five months and one year
after surgery. Awareness of this rare anorectal condition is necessary for appropriate management
particularly to avoid unnecessary abdomino-perineal resection.
Key word : Solitary Rectal Ulcer Syndrome, Case Report
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