Salar Omer, Mushtaq Fizza, Ahmed Mushtaq
Derby City General Hospital, Uttoxeter Road, Derby, DE22 3NE, UK.
J Med Case Rep. 2012 Jul 2;6:175. doi: 10.1186/1752-1947-6-175.
Defecation pain is a common problem with many etiologies implicated. Elucidating a cause requires a thorough medical history, examination and appropriate investigations, which may include endoscopy, barium enema, examination under anesthesia and magnetic resonance imaging or computed tomography. Coccydynia is a term used to describe pain in the region of the coccyx, often due to abnormal mobility of the coccyx. Non-surgical management options remain the gold-standard for coccydynia with surgery being reserved for complicated cases.
This is a case of a 67-year-old Caucasian man who presented with a two-and-a-half-year history of worsening rectal pain.
To the best of our knowledge, we describe the first case in the literature of an abnormally mobile anteverted coccyx causing predominantly defecation pain and coccydynia, successfully treated by coccygectomy. When first-line investigations fail to elucidate a cause of defecation pain one must, in the presence of unusual symptoms, consider musculoskeletal pathologies emanating from the coccyx and an orthopedic consultation must then be sought for diagnostic purposes.
排便疼痛是一个常见问题,涉及多种病因。明确病因需要详细的病史、体格检查及适当的检查,这可能包括内镜检查、钡灌肠、麻醉下检查以及磁共振成像或计算机断层扫描。尾骨痛是一个用于描述尾骨区域疼痛的术语,通常是由于尾骨活动异常所致。非手术治疗方案仍是尾骨痛的金标准,手术仅用于复杂病例。
这是一名67岁的白人男性患者,有两年半逐渐加重的直肠疼痛病史。
据我们所知,我们描述了文献中首例因异常活动且前倾的尾骨导致主要排便疼痛和尾骨痛的病例,通过尾骨切除术成功治愈。当一线检查未能明确排便疼痛的病因时,在出现异常症状的情况下,必须考虑源自尾骨的肌肉骨骼病变,此时必须寻求骨科会诊以进行诊断。