Abstract
Information on solitary rectal ulcer syndrome (SRUS) in children is limited and based on case reports only. This study was undertaken with the objective of describing the clinical history, symptoms, diagnostic work-up, and treatment of a large case series of pediatric patients with SRUS. The study was multi-center and retrospective. All pediatric endoscopists in Poland were invited to participate in the study and were asked to look through their endoscopic databases to identify SRUS cases from the last 10 years. The charts of SRUS patients were reviewed with respect to demographic data, and endoscopic and histological findings. Additionally, treatment methods and outcomes were assessed. In total, 31 patients (18 males, mean age of 13 years, range 5–18 years) were included in the study. All patients reported rectal bleeding. Other common symptoms included: abdominal pain (64.5%), perianal pain (54.8%), and passage of mucus (51.6%). The diagnostic work-up lasted from 1 to 48 months. Colonoscopic findings revealed rectal ulceration in 96.8% of patients. Therapeutic approaches included: high fiber diet (64.5%), laxatives (54.8%), topical corticosteroids (63.3%), 5-aminosalicylates administered orally and topically (29.1% and 96.8%, respectively), sucralfate (9.7%), and a biofeedback training (6.6%). Endoscopic argon plasma coagulation was performed in 2 patients and surgical intervention was necessary in 4 of them. Treatment was unsuccessful in 36% of patients. The findings of this study indicate that SRUS is rare in pediatric population, its diagnosis may be considerably delayed, and the treatment applied is often ineffective.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Abid S, Khawaja A, Bhimani SA, Ahmad Z, Hamid S, Jafri W (2012) The clinical, endoscopic and histological spectrum of the solitary rectal ulcer syndrome: a single-center experience of 116 cases. BMC Gastroenterol 12:72
Al-Brahim N, Al-Awadhi N, Al-Enezi S, Alsurayei S, Ahmad M (2009) Solitary rectal ulcer syndrome: a clinicopathological study of 13 cases. Saudi J Gastroenterol 15(3):188–192
Arhan M, Onal IK, Ozin Y, Yesil Y, Temucin T, Ozdemir M, Ulker A (2010) Solitary rectal ulcer syndrome in association with ulcerative colitis: a case report. Inflamm Bowel Dis 16(2):190–191
Blackburn C, McDermott M, Bourke B (2012) Clinical presentation of and outcome for solitary rectal ulcer syndrome in children. J Pediatr Gastroenterol Nutr 54(2):263–265
Dehghani SM, Haghighata M, Imanieha MH, Geramizadeh B (2008) Solitary rectal ulcer syndrome in children: a prospective study of cases from southern Iran. Eur J Gastroenterol Hepatol 20(2):93–95
Dehghani SM, Malekpour A, Haghighat M (2012) Solitary rectal ulcer syndrome in children: a literature review. World J Gastroenterol 18(45):6541–6545
Ertem D, Acar Y, Karaa EK, Pehlivanoglu E (2002) A rare and often unrecognized cause of hematochezia and tenesmus in childhood: solitary rectal ulcer syndrome. Pediatrics 110(6):e79
Halligan S, Sultan A, Rottenberg G, Bartram CI (1995) Endosonography of the anal sphincters in solitary rectal ulcer syndrome. Int J Color Dis 10(2):79–82
Iwańczak B, Blitek A, Krzesiek E (2003) Preliminary evaluation of the treatment of the children with solitary rectal ulcer, functional constipation and encopresis using biofeedback. Adv Clin Exp Med 12(6):769–775
Kc S, Sharma S, Basnet B, Mishra AK (2008) Solitary rectal ulcer syndrome: uncommon cause of rectal bleeding in children. J Nepal Med Assoc 47(172):238–240
Kochhar R, Mehta SK, Aggarwal R, Dhar A, Patel F (1990) Sucralfate enema in ulcerative rectosigmoid lesions. Dis Colon Rectum 33(1):49–51
Mackle EJ, Parks TG (1986) The pathogenesis and pathophysiology of rectal prolapse and solitary rectal ulcer syndrome. Clin Gastroenterol 15(4):985–1002
Malouf AJ, Vaizey CJ, Kamm MA (2001) Results of behavioral treatment (biofeedback) for solitary rectal ulcer syndrome. Dis Colon Rectum 44(1):72–76
Perito ER, Mileti E, Dalal DH, Cho SJ, Ferrell LD, McCracken M et al (2012) Solitary rectal ulcer syndrome in children and adolescents. J Pediatr Gastroenterol Nutr 54(2):266–270
Saadah OI, Al-Hubayshi MS, Ghanem AT (2010) Solitary rectal ulcer syndrome presenting as polypoid mass lesions in a young girl. World J Gastrointest Oncol 2(8):332–334
Sharara AI, Azar C, Amr SS, Haddad M, Eloubeidi MA (2005) Solitary rectal ulcer syndrome: endoscopic spectrum and review of the literature. Gastrointest Endosc 62(5):755–762
Sharma A, Misra A, Ghoshal UC (2014) Fecal evacuation disorder among patients with solitary rectal ulcer syndrome: a case-control study. J Neurogastroenterol Motil 20(4):531–538
Somani SK, Ghosh A, Avasthi G, Goyal R, Gupta P (2010) Healing of solitary rectal ulcers with multiple sessions of argon plasma coagulation. Dig Endosc 22(2):107–111
Suresh N, Ganesh R, Sathiyasekaran M (2010) Solitary rectal ulcer syndrome: a case series. Indian Pediatr 47(12):1059–1061
Tjandra JJ, Fazio VW, Church JM, Lavery IC, Oakley JR, Milsom JW (1992) Clinical conundrum of solitary rectal ulcer. Dis Colon Rectum 35(3):227–234
Urgancı N, Kalyoncu D, Eken KG (2013) Solitary rectal ulcer syndrome in children: a report of six cases. Gut Liver 7(6):752–755
Vaizey CJ, Roy AJ, Kamm MA (1997) Prospective evaluation of the treatment of solitary rectal ulcer syndrome with biofeedback. Gut 41(6):817–820
Woynarowski M, Ignys I, Celinska-Cedro D et al (2008) Paediatric endoscopy in Poland in 2007. Pediatr Współcz Gastroenterol Hepatol Zywienie Dziecka 10(3):158–163
Woynarowski M, Czkwianianc E, Respekta E et al (2013) Paediatric endoscopy in Poland in 2012. Pediatr Współcz Gastroenterol Hepatol Zywienie Dziecka 15(2):47–54
Zargar SA, Khuroo MS, Mahajan R (1991) Sucralfate retention enemas in solitary rectal ulcer. Dis Colon Rectum 34(6):455–457
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2017 Springer International Publishing Switzerland
About this chapter
Cite this chapter
Kowalska-Duplaga, K. et al. (2017). Solitary Rectal Ulcer Syndrome in Children: A Case Series Study. In: Pokorski, M. (eds) Clinical Research and Practice. Advances in Experimental Medicine and Biology(), vol 1020. Springer, Cham. https://doi.org/10.1007/5584_2017_2
Download citation
DOI: https://doi.org/10.1007/5584_2017_2
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-319-65444-7
Online ISBN: 978-3-319-65445-4
eBook Packages: Biomedical and Life SciencesBiomedical and Life Sciences (R0)