Abreu Marlene, Azevedo Alves Raquel, Pinto João, Campos Miguel, Aroso Sofia
Pediatric Department, Local Health Unit of Matosinhos, Matosinhos, Portugal.
Department of Pathology, Local Health Unit of Matosinhos, Matosinhos, Portugal.
GE Port J Gastroenterol. 2017 May;24(3):142-146. doi: 10.1159/000450900. Epub 2017 Jan 18.
Solitary rectal ulcer syndrome (SRUS) is an uncommon benign rectal disease. Mostly young adults are affected, and it is rare in paediatric populations.
We present a 12-year-old girl with a 6-month history of tenesmus, frequent defaecation, and bloody stools with mucus. There was no previous history of constipation or other symptoms. At the first visit, physical examination and routine laboratory test results were normal. A stool examination for bacteria and parasites was negative. Colonoscopy revealed a single ulcer in the distal rectum 6 cm from the anal margin. SRUS was confirmed by biopsy. Despite conservative measures, the symptoms persisted. A defaecation proctography showed a small rectocele with no rectal mucosal prolapse. Because of its proximity to the anal sphincter, no surgical intervention was performed.
The present case illustrates how difficult the management of SRUS is. Multicentre studies are needed to establish treatment protocols for children.
孤立性直肠溃疡综合征（SRUS）是一种罕见的良性直肠疾病。主要影响年轻人，在儿科人群中罕见。
我们报告一名12岁女孩，有6个月的里急后重、频繁排便及黏液血便病史。既往无便秘或其他症状史。初次就诊时，体格检查和常规实验室检查结果正常。粪便细菌和寄生虫检查阴性。结肠镜检查发现距肛缘6 cm的直肠远端有一个单发溃疡。活检确诊为SRUS。尽管采取了保守措施，症状仍持续存在。排粪造影显示有一个小直肠膨出，无直肠黏膜脱垂。由于其靠近肛门括约肌，未进行手术干预。
本病例说明了SRUS的治疗难度有多大。需要进行多中心研究以建立儿童治疗方案。
