Vaizey C J, van den Bogaerde J B, Emmanuel A V, Talbot I C, Nicholls R J, Kamm M A
Middlesex Hospital, London, UK.
Br J Surg. 1998 Dec;85(12):1617-23. doi: 10.1046/j.1365-2168.1998.00935.x.
Solitary rectal ulcer syndrome is a rare disorder characterized by erythema or ulceration of the rectal wall, associated with typical histological features, and disturbed defaecatory behaviour with the passage of blood and mucus.
This is a review based on a literature search using a computer database (Medline) and manual cross-referencing.
The pathogenesis is likely to vary in different patients; it includes trauma from straining, direct digital trauma and possibly primary neuromuscular pathology. The histological findings of extension of the muscularis mucosa between crypts and muscularis propria disorganization on full-thickness specimens are characteristic. Biofeedback defaecation retraining, including habit training, can lead to symptom improvement and return to work in a majority of patients. Abdominal rectopexy offers long-term symptom improvement in approximately 50 per cent of patients. Rectal ulceration may persist after any treatment, even if symptoms improve.
Behavioural therapy and carefully considered operations offer the best treatment results. Further work on psychological factors and neuromuscular and vascular pathology is required.
孤立性直肠溃疡综合征是一种罕见的疾病，其特征为直肠壁红斑或溃疡，伴有典型的组织学特征，以及排便行为紊乱，伴有便血和黏液便。
这是一项基于计算机数据库（Medline）文献检索和手工交叉引用的综述。
不同患者的发病机制可能不同；包括用力排便导致的创伤、直接的指诊创伤以及可能的原发性神经肌肉病变。隐窝间黏膜肌层延伸和全层标本中固有肌层紊乱的组织学表现具有特征性。生物反馈排便训练，包括习惯训练，可使大多数患者症状改善并恢复工作。腹直肌固定术可使约50%的患者长期症状改善。即使症状改善，任何治疗后直肠溃疡仍可能持续存在。
行为疗法和经过审慎考虑的手术可提供最佳治疗效果。需要进一步研究心理因素以及神经肌肉和血管病变。
