Na Sun Kyung, Jung Hye-Kyung, Shim Ki-Nam, Jung Sung-Ae, Chung Soon Sup
Department of Internal Medicine, Ewha Womans University College of Medicine, Seoul, Korea.
Department of Surgery, Ewha Womans University College of Medicine, Seoul, Korea.
Ann Coloproctol. 2014 Feb;30(1):50-3. doi: 10.3393/ac.2014.30.1.50. Epub 2014 Feb 28.
Diverticula are frequently seen in the sigmoid, descending, ascending and transverse colons whereas rectal diverticula are extremely rare. The stapled rectal mucosectomy for the treatment of a prolapsed hemorrhoid is less painful and has lower morbidity; therefore, it has been commonly used despite possible complications. This paper reports a case of a rectal diverticulum that developed after a procedure for prolapsed hemorrhoids (PPH). A 42-year-old man with a history of hemorrhoidectomies came to the hospital because of constipation. On sigmoidoscopy, a 2-cm-sized, feces-filled pocket was located just above the anorectal junction. After removal of the fecal material, a huge rectal diverticulum (-4 cm in diameter) was seen. Pelvic magnetic resonance imaging (MRI) confirmed the diagnosis of rectal diverticulum outpouching through the muscular layer of the intestine in a left posterolateral direction. The patient was discharged without complication after a transanal diverticulectomy had been performed, and the direct rectal wall had been repaired.
憩室常见于乙状结肠、降结肠、升结肠和横结肠，而直肠憩室极为罕见。用于治疗痔脱垂的吻合器直肠黏膜切除术疼痛较轻且发病率较低；因此，尽管可能有并发症，它仍被广泛使用。本文报告一例痔脱垂手术（PPH）后发生直肠憩室的病例。一名有痔切除术史的42岁男性因便秘前来医院就诊。在乙状结肠镜检查中，在肛门直肠交界处上方发现一个2厘米大小、充满粪便的袋状物。清除粪便后，可见一个巨大的直肠憩室（直径约4厘米）。盆腔磁共振成像（MRI）证实诊断为直肠憩室经肠肌层向左后外侧方向突出。经肛门憩室切除并修复直肠直接壁后，患者无并发症出院。
