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[7例儿童孤立性直肠溃疡综合征分析]

[Analysis of solitary rectal ulcer syndrome in 7 children].

作者信息

Xiong L Y, Geng L L, Chen P Y, Ren L, Li H W, Xie J, Wu P Q, Gong S T

机构信息

Department of Gastroenterology, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, National Children's Medical Center for South Central Region, Guangzhou 510623, China.

出版信息

Zhonghua Er Ke Za Zhi. 2022 Sep 2;60(9):920-924. doi: 10.3760/cma.j.cn112140-20220221-00137.

Abstract

To analyze the clinical features, treatment and prognosis of solitary rectal ulcer syndrome (SRUS) in children. The clinical data of 7 children who were diagnosed with SRUS in Department of Gastroenterology in Guangzhou Women and Children' Medical Center from January 2019 to December 2021 were retrospectively analyzed. The clinical data including general demographics, clinical presentations, endoscopic and histologic features, treatment and outcome were extracted from hospital medical records. The 7 patients were all males, and the age of onset was 6-12 years. The course before diagnosis was 2-36 months. The most common symptom was rectal bleeding (6 cases) and most common findings at initial colonoscopy were ulcer in 3 cases and protuberance in 4 cases, both located only in rectum. The intestinal histopathology of 5 cases showed characteristic fibromuscular obliteration of lamina propria. Five children were treated with mesalamine granules or suppositories, and 2 cases underwent local excision. The follow-up lasted for 5-24 months and found symptoms relieved in 5 cases, improved in 1 case, and no remission in 1 case. Colonoscopy after the treatment was performed in 5 children, among whom 2 cases achieved mucosal healing. SRUS in children is mainly presented with rectal bleeding, and has characteristic histological change of ulcer and protuberance in endoscopy. Pathology is crucial for diagnosis and differential diagnosis. Both the medical and surgical treatment are effective for SRUS.

摘要

分析儿童孤立性直肠溃疡综合征(SRUS)的临床特征、治疗及预后。回顾性分析2019年1月至2021年12月在广州妇女儿童医疗中心消化内科确诊为SRUS的7例患儿的临床资料。从医院病历中提取一般人口统计学、临床表现、内镜及组织学特征、治疗及结局等临床资料。7例患者均为男性,发病年龄6 - 12岁。确诊前病程2 - 36个月。最常见症状为直肠出血(6例),初次结肠镜检查最常见表现为溃疡3例、隆起4例,均仅位于直肠。5例肠道组织病理学表现为特征性的固有层纤维肌性闭塞。5例患儿接受美沙拉嗪颗粒或栓剂治疗,2例行局部切除。随访5 - 24个月,5例症状缓解,1例改善,1例未缓解。5例患儿治疗后行结肠镜检查,其中2例黏膜愈合。儿童SRUS主要表现为直肠出血,内镜下有溃疡及隆起的特征性组织学改变。病理对诊断及鉴别诊断至关重要。内科及外科治疗对SRUS均有效。

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