Womack N R, Williams N S, Holmfield J H, Morrison J F
Surgical Unit, London Hospital, Whitechapel.
Gut. 1987 Oct;28(10):1228-33. doi: 10.1136/gut.28.10.1228.
The cause of solitary rectal ulceration has been investigated using a method that radiologically visualises rectal voiding whilst simultaneously measuring intrarectal pressure and external anal sphincter electromyographic activity. Control subjects and patients with the solitary rectal ulcer syndrome, both with and without mucosal ulceration, have been studied. A high incidence of rectal prolapse (94%) was present in the patients who voided. Overactivity of the anal sphincter during evacuation contributed to the fact that patients with mucosal ulceration required higher intrarectal pressures to void than the controls and the patients without mucosal ulceration. The results indicate that a combination of rectal prolapse and a high voiding pressure may act to cause the mucosal ulceration in this syndrome by exposing the rectal wall to a high transmural pressure gradient.
采用一种能通过放射学手段观察直肠排尿情况，同时测量直肠内压力和肛门外括约肌肌电图活动的方法，对孤立性直肠溃疡的病因进行了研究。研究对象包括对照组以及患有孤立性直肠溃疡综合征的患者，这些患者既有黏膜溃疡的，也有未出现黏膜溃疡的。排尿的患者中直肠脱垂发生率很高（94%）。排空过程中肛门括约肌过度活动导致出现黏膜溃疡的患者比对照组及未出现黏膜溃疡的患者需要更高的直肠内压力来排尿。结果表明，直肠脱垂和高排尿压力相结合，可能通过使直肠壁暴露于高跨壁压力梯度而导致该综合征中的黏膜溃疡。
