Meurette Guillaume, Regenet Nicolas, Frampas Eric, Sagan Christine, Le Borgne Joël, Lehur Paul-Antoine
Clinique Chirurgicale 2, CHU Hôtel-Dieu, Nantes.
Gastroenterol Clin Biol. 2006 Mar;30(3):382-90. doi: 10.1016/s0399-8320(06)73192-x.
The solitary rectal ulcer syndrome is a rare debilitating disorder of the rectum characterized by perianal chronic pain with passage of blood and mucus. The pathogenesis remains uncertain, rectal prolapse and trauma from straining are the main hypothesis. The diagnosis includes clinical symptoms associated with endoscopic lesion (erythema, ulcer or polypoïd lesion) and histological features. Mano-metric studies and defecography are helpful to determinate an underlying defecation disorder or rectal prolapse. The treatment is controversial including a conservative option (medications and behavioural therapy) with poor long term results, and the surgical option (treatment of a rectal prolapse with or without resection of the lesion), more aggressive with uncertain results in a long follow-up period.
孤立性直肠溃疡综合征是一种罕见的直肠衰弱性疾病,其特征为肛周慢性疼痛并伴有便血和黏液便。发病机制尚不确定,主要假说是直肠脱垂和用力排便所致创伤。诊断包括与内镜下病变(红斑、溃疡或息肉样病变)相关的临床症状以及组织学特征。测压研究和排粪造影有助于确定潜在的排便障碍或直肠脱垂。治疗存在争议,包括保守治疗(药物和行为疗法),但长期效果不佳,以及手术治疗(治疗直肠脱垂,可切除或不切除病变),这种方法更积极,但长期随访结果不确定。