Dehghani Seyed Mohsen, Bahmanyar Maryam, Geramizadeh Bita, Alizadeh Anahita, Haghighat Mahmood
Seyed Mohsen Dehghani, Maryam Bahmanyar, Bita Geramizadeh, Anahita Alizadeh, Mahmood Haghighat, Department of Pediatric Gastroenterology, Gastroenterohepatology Research Center, Shiraz Transplant Research Center, Nemazee Teaching Hospital, School of Medicine, Shiraz University of Medical Sciences, Shiraz 71937-11351, Iran.
World J Clin Pediatr. 2016 Aug 8;5(3):343-8. doi: 10.5409/wjcp.v5.i3.343.
To evaluate the clinicopathologic characteristics of the children with solitary rectal ulcer.
Fifty-five children with a confirmed diagnosis of solitary rectal ulcer were studied in a period of 11 years from March 2003 to March 2014. All data were collected from the patients, their parents and medical records in the hospital.
From 55 studied patients, 41 were male (74.5%) and 14 female (25.5%). The mean age of the patients was 10.4 ± 3.7 years and the average time period from the beginning of symptoms to diagnosis of solitary rectal ulcer was 15.5 ± 11.2 mo. The most common clinical symptoms in our patients were rectal bleeding (n = 54, 98.2%) and straining during defecation or forceful defecation (n = 50, 90.9%). Other symptoms were as follows respectively: Sense of incomplete evacuation (n = 34, 61.8%), mucorrhea (n = 29, 52.7%), constipation (n = 14, 25.4%), tenesmus and cramping (n = 10, 18.2%), diarrhea (n = 9, 16.4%), and rectal pain (n = 5, 9.1%). The colonoscopic examination revealed 67.3% ulcer, 12.7% polypoid lesions, 10.9% erythema, 7.3% both polypoid lesions and ulcer, and 1.8% normal. Most of the lesions were in the rectosigmoid area at a distance of 4-6 cm from the anal margin. Finally, 69.8% of the patients recovered successfully with conservative, medical and surgical management.
The study revealed that solitary rectal ulcer is not so uncommon despite what was seen in previous studies. As the most common symptom was rectal bleeding, clinicians and pathologists should be familiar with this disorder and common symptoms in order to prevent its complications with early diagnosis.
评估孤立性直肠溃疡患儿的临床病理特征。
对2003年3月至2014年3月期间确诊为孤立性直肠溃疡的55例患儿进行了为期11年的研究。所有数据均从患者、其父母及医院病历中收集。
在55例研究患者中，男性41例（74.5%），女性14例（25.5%）。患者的平均年龄为10.4±3.7岁，从症状出现到诊断为孤立性直肠溃疡的平均时间为15.5±11.2个月。我们患者中最常见的临床症状是直肠出血（n = 54，98.2%）和排便时用力或强力排便（n = 50，90.9%）。其他症状分别如下：排便不尽感（n = 34，61.8%）、黏液便（n = 29，52.7%）、便秘（n = 14，25.4%）、里急后重和绞痛（n = 10，18.2%）、腹泻（n = 9，16.4%）以及直肠疼痛（n = 5，9.1%）。结肠镜检查显示溃疡占67.3%，息肉样病变占12.7%，红斑占10.9%，息肉样病变和溃疡均有占7.3%，正常占1.8%。大多数病变位于距肛缘4 - 6 cm的直肠乙状结肠区域。最后，69.8%的患者通过保守治疗、药物治疗和手术治疗成功康复。
该研究表明，尽管先前研究显示并非如此，但孤立性直肠溃疡并不罕见。由于最常见的症状是直肠出血，临床医生和病理学家应熟悉这种疾病及其常见症状，以便通过早期诊断预防其并发症。
