Kamabu Kinyamaniyi, Geoffrey Okullo Obong, Kiyaka Sonye Magugu, Francis Mamadi Owera, Arab Abdikadar Mohamud, Sikakulya Franck Katembo
Faculty of Clinical Medicine and Dentistry, Department of Surgery, Kampala International University Western Campus, Ishaka-Bushenyi, Uganda; Department of Surgery Lira Regional Referral Hospital, Uganda.
Department of Surgery Lira Regional Referral Hospital, Uganda.
Int J Surg Case Rep. 2023 Feb;103:107894. doi: 10.1016/j.ijscr.2023.107894. Epub 2023 Jan 11.
Anal stenosis following hemorrhoids surgery is rare, and very distressing to the patients. It is graded according to its severity namely mild, moderate or severe. Majority of severe cases require surgery. The treatment is complex shown by the multiplicity of flaps and techniques described in the literature. This case report then reminds surgeons about the complications of hemorrhoidectomy and the complexity of their management. In addition, it challenges the surgeons about their practice on hemorrhoids.
A 30-year-old male who presented with difficulty in passing stool with intermittent low abdominal pain for 4 weeks following a surgery for hemorrhoids. A House Advancement Flap was designed to match the transverse incisions and hence the width of the mucosal defect to be replaced. Any intra- or postoperative complications were noted and the patient was discharged on the second postoperative day from the hospital. Patient had no complaints in the post-discharge period.
Overzealous hemorrhoidectomy is one of the primary causes of stenosis of anal canal. Other causes that have been reported include anorectal diseases, other anorectal surgeries and radiotherapy. Physical examination majorly leads to the diagnosis of anal stenosis. Its treatment is conservative in mild cases while in severe anal stenosis a House Advancement Flap is one of the possible surgical management options.
Anal stenosis is a rare condition which requires good evaluation for its better management. Given its simplicity and successful results, a House Advancement Flap anoplasty is a reliable treatment of severe anal stenosis.
痔疮手术后发生肛管狭窄较为罕见，但会给患者带来极大痛苦。肛管狭窄根据严重程度分为轻度、中度或重度。大多数重度病例需要手术治疗。文献中描述的多种皮瓣和技术表明其治疗较为复杂。本病例报告提醒外科医生注意痔切除术的并发症及其处理的复杂性。此外，它也促使外科医生反思他们在痔疮治疗方面的做法。
一名30岁男性，在痔疮手术后4周出现排便困难并伴有间歇性下腹痛。设计了霍斯推进皮瓣以匹配横向切口，从而确定要替换的黏膜缺损宽度。记录任何术中或术后并发症，患者术后第二天出院。出院后患者无不适主诉。
过度激进的痔切除术是肛管狭窄的主要原因之一。其他已报道的原因包括肛肠疾病、其他肛肠手术和放疗。体格检查主要用于肛管狭窄的诊断。轻度病例采用保守治疗，而重度肛管狭窄时，霍斯推进皮瓣是可能的手术治疗选择之一。
肛管狭窄是一种罕见疾病，需要进行充分评估以实现更好的治疗。鉴于其操作简单且效果良好，霍斯推进皮瓣肛门成形术是治疗重度肛管狭窄的可靠方法。
