A Case of Solitary Rectal Ulcer Syndrome Treated by Transsacral Proctomucosectomy

Yoshiya Kawaguchi*, Toshikuni Nishikawa, Shunzo Maetani, Takayoshi Tobe

First Department of Surgery, Kyoto University School of Medicine
*Department of Surgery, Kurashiki Central Hospital

We report a case of solitary rectal ulcer syndrome treated by trans-sacral resection of the rectal mucosa. For the past 8 years, this 20-year-old man had suffered from rectal bleeding, mucous discharge and tenesmus despite medical treatments and restraint from straining at defecation. There were multiple polypoid lesions in the lower rectum, and biopsy showed fibromuscular obliteration of the lamina propria. After trans-sacral, longitudinal incision of the posterior wall of the rectum, the entire circumference of the mucosa was dissected from the muscular coat, and an 8 cm long mucosal tube was made. Then the mucosal tube was resected together with the lesions, 0.5 cm above the dentate line. The denudued muscularis was longitudinally plicated to approximate both cut ends of the mucosa. After that, the mucosal cut ends were sutured. Postoperative anorectal manometry showed a normal pattern and the patient remains free of symptoms 25 months after the operation. This is the second case of solitary rectal ulcer syndrome cured by our method of mucosal proctectomy.

Key words
solitary rectal ulcer syndrome, transsacral proctomucosectomy, mucosal prolapse syndrome

Reprint requests
Yoshiya Kawaguchi Kurashiki Central Hospital
1-1-1 Miwa, Kurashiki, 710 JAPAN

Accepted
November 20, 1991

To read the PDF file you will need Abobe Reader installed on your computer.