Abstract
A retrospective analysis of the clinical profile, endoscopic features and management of 22 children (age 18 months–18 years) diagnosed as solitary rectal ulcer syndrome is presented. The majority (81.8%) were ≥8 years of age. Rectal bleeding was the presenting feature in all the children. Mucorrhea, constipation, tenesmus and rectal prolapse were observed in 77.3%, 63.6%, 59% and 13.6% children, respectively. Colonoscopy showed classical single rectal ulcer in 68.2% and multiple ulcers in 22.7%. Polypoidal and erosive lesions were documented in 4.5% each. The medical management comprised of bowel training and high fibre diet for all children. The other modalities included oral 5-amino salicylate (59%), sucralfate enema (4.5%) and rectal mesalamine in 9%. 64% children recovered and 13.6 % had recurrence of symptoms.
This is a preview of subscription content, log in via an institution to check access.
References
Nagar AB, Proctor DD. Ulcers of the small and large intestine. In: Feldman M, Friedman LS, Brandt LJ, Editors. Sleisenger and Fordtrans. Gastrointestinal and Liver Disease: Pathophysiology, Diagnosis and Management. Volume 2. 8th edition. Philadelphia: Saunders Elsevier; 2006. p. 2587–2598.
Perez LC, Vicent VM, Verge CR, Roman ALS, Milicua JM. The three-lies disease: Solitary rectal ulcer syndrome. Rev Esp Enferm Dig 2007;99:663–666.
Dehghani SM, Haghighat M, Imanieh MH, Geramizadeh B. Solitary rectal ulcer syndrome in children: a prospective study of cases from southern Iran. Eur J Gastroenterol Hepatol 2008;20:93–95.
Esmaeily H. Histopathological misdiagnosis of solitary rectal ulcer syndrome. Res J Biol Sci 2008;3:1171–1177.
Eigenmann PA, Lecoultre C, Cox J. Solitary rectal ulcer: an unusual cause of rectal bleeding in children. Eur J Pediatr 1992;151:658–660.
Turck D, Michaud L. Lower gastrointestinal bleeding. In: Walker WA, Goulet OJ, Kleinman RE, Sherman PM, Shneidear BL, Sandarson IR, editors. Pediatric Gastrointestinal Disease: Pathophysio-logy, Diagnosis and Management. Volume 1, 4th edition. USA: BC Decker; 2004. p. 266–280.
Ertem D, Acar Y, Karaa EK, Pehlivanoglu E. A rare and often unrecognized cause of hematochezia and tenesmus in childhood: Solitary rectal ulcer syndrome. Pediatrics 2002;110:279.
Al-Brahim N, Al-Awadhi N, Al-Enezi S, Alsurayei S, Ahmad M. Solitary rectal ulcer syndrome: A clinicopathological study of 13 cases. Saudi J Gastroenterol 2009;15:188–192.
Gudbole P, Botterill I, Newell SJ, Sagar PM, Stringer MD. Solitary rectal ulcer syndrome in children. J R Coll Surg Edinb 2000;45:411–414.
Flet-Bersma RFJ, Cuesta MA. Rectal prolapse, rectal intussusceptions, rectocele and solitary rectal ulcer syndrome. Gastroenterol Clin North Am 2001;30:199–222.
Zargar SA, Khuroo MS, Mahajan R. Sucralfate retension enema in solitary rectal ulcer. Dis Colon Rectum 1991;34:455–457.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Suresh, N., Ganesh, R. & Sathiyasekaran, M. Solitary rectal ulcer syndrome: A case series. Indian Pediatr 47, 1059–1061 (2010). https://doi.org/10.1007/s13312-010-0177-0
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s13312-010-0177-0