直肠重复畸形囊肿的一种罕见表现。
An unusual presentation of a rectal duplication cyst.
作者信息
Jackson Katharine L, Peche William J, Rollins Michael D
机构信息
Department of General Surgery, University of Utah Hospital, Salt Lake City, UT 84132, USA.
出版信息
Int J Surg Case Rep. 2012;3(7):314-5. doi: 10.1016/j.ijscr.2012.03.015. Epub 2012 Apr 5.
INTRODUCTION
Intestinal duplications are rare developmental anomalies that can occur anywhere along the gastrointestinal tract. Rectal duplication cysts account for approximately 4% of all duplication cysts. They usually present in childhood with symptoms of mass effect, local infection or more rarely with rectal bleeding from ectopic gastric mucosa.
PRESENTATION OF CASE
A 26year old male presented with a history of bright red blood per rectum. On examination a mucosal defect with an associated cavity adjacent to the rectum was identified. This was confirmed with rigid proctoscopy and CT scan imaging. A complete transanal excision was performed.
DISCUSSION
Rectal duplication cysts are more common in pediatric patients. They more frequently present with symptoms of mass effect or local infection than with rectal bleeding. In adult patients they are a rare cause of rectal bleeding. Definitive treatment is with surgical excision. A transanal, transcoccygeal, posterior sagittal or a combined abdominoperineal approach may be used depending on anatomic characteristics of the duplication cyst.
CONCLUSION
We present a rare case of a rectal duplication cyst presenting in adulthood with rectal bleeding, managed with transanal excision.
引言
肠道重复畸形是罕见的发育异常，可发生于胃肠道的任何部位。直肠重复囊肿约占所有重复囊肿的4%。它们通常在儿童期出现，表现为占位效应、局部感染症状，较少见的是异位胃黏膜导致的直肠出血。
病例介绍
一名26岁男性，有直肠鲜红色便血病史。检查发现直肠旁有一个伴有腔隙的黏膜缺损。硬式直肠镜检查和CT扫描成像证实了这一情况。进行了经肛门完整切除。
讨论
直肠重复囊肿在儿科患者中更为常见。它们出现占位效应或局部感染症状的频率高于直肠出血。在成年患者中，它们是直肠出血的罕见原因。明确的治疗方法是手术切除。根据重复囊肿的解剖特征，可采用经肛门、经尾骨、后矢状或联合腹会阴入路。
结论
我们报告了一例罕见的成年直肠重复囊肿病例，以直肠出血为表现，采用经肛门切除进行治疗。
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