Kołodziejczak Małgorzata, Santoro Giulio A, Sobocki Jacek, Szopiński Tomasz, Wiączek Anna, Sudoł-Szopińska Iwona
Warsaw Proctology Centre, Saint Elisabeth Hospital, Warsaw, Poland.
Department of Colorectal Surgery, Digestive Disease Institute, Cleveland Clinic Abu Dhabi, Abu Dhabi, UAE.
Med Ultrason. 2017 Apr 22;19(2):228-231. doi: 10.11152/mu-928.
Malformations of the rectum and urinary tract frequently coexist, and the prevalence of urogenital defects in patients with a rectal defect ranges from 20 to 54%. In most patients, anorectal malformations are diagnosed and treated surgically in early childhood. In this report, we present a case of a 52-year-old male with a history of urological operations in infancy due to a congenital urethral malformation and multiple recurrent episodes of perineal abscesses with urinary retention. Anorectal endosonography and magnetic resonance imaging revealed the presence of a large cystic lesion adjacent to the rectal wall which became smaller at the level of the puborectalis. The walls of the lesion had a layered structure identical to the wall of the rectum. In addition, the examinations showed hypotrophy of the left lobe of the prostate and lack of left semnal vesicles. Thus, the lesion was diagnosed as duplication of the rectum or rectal diverticulum. Surgery was performed by an interdisciplinary team of colorectal surgeons and urologist. The lesion was removed laparoscopically. The pathological report revealed that the cystic wall was typical of the intestinal wall, consistent with a diagnosis of rectal duplication.
直肠和泌尿道畸形常同时存在，直肠畸形患者中泌尿生殖系统缺陷的发生率在20%至54%之间。大多数患者的肛门直肠畸形在幼儿期就被诊断出来并接受了手术治疗。在本报告中，我们介绍了一例52岁男性患者，他在婴儿期因先天性尿道畸形接受了泌尿外科手术，并有多次会阴部脓肿伴尿潴留反复发作的病史。肛门直肠超声检查和磁共振成像显示，直肠壁旁有一个大的囊性病变，在耻骨直肠肌水平处变小。病变的壁具有与直肠壁相同的分层结构。此外，检查显示前列腺左叶萎缩，左侧精囊缺如。因此，该病变被诊断为直肠重复畸形或直肠憩室。手术由结直肠外科医生和泌尿外科医生组成的跨学科团队进行。通过腹腔镜切除了病变。病理报告显示，囊性壁为典型的肠壁，符合直肠重复畸形的诊断。
