Xu Yingfeng, Wang Zhiting, Hu Jianwen, Xie Jiajia, Chen Shiwei, Ke Ke
Department of Anorectal Surgery, The Seventh Clinical College of Guangzhou University of Chinese Medicine, Shenzhen, China.
Department of Classical Ward, The Seventh Clinical College of Guangzhou University of Chinese Medicine, Shenzhen, China.
Front Surg. 2025 Apr 17;12:1559084. doi: 10.3389/fsurg.2025.1559084. eCollection 2025.
Rectal necrosis represents the extreme progression of ischemic proctitis. Given the unique blood supply of the rectum, which features an extensive collateral circulation, cases of rectal necrosis are extremely rare, accounting for 2%-5% of the ischemic colitis cases. The etiology and pathogenesis of rectal necrosis encompass acute vascular occlusion, severe vascular diseases, low blood flow states, and factors such as radiotherapy, vasculitis, and mesenteric venous myointimal hyperplasia. Herein, we report a rare case of perirectal abscess complicated by rectal necrosis at the Anorectal Surgery Department of Bao'an Traditional Chinese Medicine Hospital in Shenzhen. The patient underwent a one-stage incision and drainage for a rectal abscess, followed by sigmoid colostomy and a two-stage reversal of the sigmoid colostomy; all procedures were performed through multidisciplinary collaboration. The surgical outcome was favorable after a 6-month follow-up.
直肠坏死是缺血性直肠炎的极端进展形式。鉴于直肠独特的血液供应，其具有广泛的侧支循环，直肠坏死病例极为罕见，占缺血性结肠炎病例的2%-5%。直肠坏死的病因和发病机制包括急性血管闭塞、严重血管疾病、低血流状态以及放疗、血管炎和肠系膜静脉肌内膜增生等因素。在此，我们报告深圳市宝安区中医院肛肠外科1例罕见的直肠周围脓肿合并直肠坏死病例。该患者接受了直肠脓肿一期切开引流术，随后行乙状结肠造口术及二期乙状结肠造口还纳术；所有手术均通过多学科协作完成。随访6个月后手术效果良好。
