Asai Megumi, Wood Elizabeth, Reickert Craig A
Division of Colon and Rectal Surgery, Henry Ford Hospital, Detroit, MI, United States.
Division of Colon and Rectal Surgery, Henry Ford Hospital, Detroit, MI, United States.
Int J Surg Case Rep. 2020;72:524-527. doi: 10.1016/j.ijscr.2020.06.023. Epub 2020 Jun 12.
Enterocele is a herniation of the small bowel through the cul-de-sac. It is uncommon and most often seen in elder females. Large enterocele manifesting as rectal prolapse is exceedingly rare and only few cases are reported previously. Due to it rarity, the best surgical treatment is not yet established especially in male patients. We present a case of enterocele causing rectal prolapse in a male patient that was treated surgically.
A 47-year-old African American male with chronic constipation and straining presented with manually reducible rectal prolapse. A defecography revealed a large enterocele prolapsing through the anterior rectal wall. The patient underwent an open posterior suture rectopexy with peritoneoplasty. His symptoms completely resolved after surgery, and repeat defecography three months after the procedure showed no sign of recurrence.
DISCUSSION & CONCLUSION: Extraperineal enterocele in male is a rare disease. Rectopexy with peritoneoplasty can provide a great symptom relieve and improvement on defecography. Long-term outcome should be evaluated.
肠膨出是小肠经直肠陷凹的疝出。它并不常见,多见于老年女性。表现为直肠脱垂的巨大肠膨出极为罕见,此前仅有少数病例报道。由于其罕见性,尤其是在男性患者中,最佳的手术治疗方法尚未确立。我们报告一例男性患者因肠膨出导致直肠脱垂并接受手术治疗的病例。
一名47岁患有慢性便秘且排便用力的非裔美国男性,出现可手法还纳的直肠脱垂。排粪造影显示一个巨大的肠膨出经直肠前壁脱垂。该患者接受了开放性后路缝合直肠固定术及腹膜成形术。术后其症状完全缓解,术后三个月复查排粪造影未显示复发迹象。
男性会阴外肠膨出是一种罕见疾病。直肠固定术联合腹膜成形术可显著缓解症状并改善排粪造影结果。应评估长期疗效。