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Solitary Rectal Ulcer Syndrome in Children: A Case Series Study

  • K. Kowalska-Duplaga
  • I. Lazowska-Przeorek
  • K. Karolewska-Bochenek
  • M. Woynarowski
  • G. Czaja-Bulsa
  • A. Stawarski
  • S. Pieczarkowski
  • E. Hapyn
  • J. Jozefczuk
  • B. Korczowski
  • A. Szaflarska-Poplawska
  • A. Banaszkiewicz
Chapter
Part of the Advances in Experimental Medicine and Biology book series (AEMB, volume 1020)

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.

Keywords

Solitary rectal ulcer syndrome Children Rectal bleeding 

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Copyright information

© Springer International Publishing Switzerland 2017

Authors and Affiliations

  • K. Kowalska-Duplaga
    • 1
  • I. Lazowska-Przeorek
    • 2
  • K. Karolewska-Bochenek
    • 2
  • M. Woynarowski
    • 3
  • G. Czaja-Bulsa
    • 4
  • A. Stawarski
    • 5
  • S. Pieczarkowski
    • 1
  • E. Hapyn
    • 6
  • J. Jozefczuk
    • 7
  • B. Korczowski
    • 8
  • A. Szaflarska-Poplawska
    • 9
  • A. Banaszkiewicz
    • 2
  1. 1.Department of Pediatric, Gastroenterology and NutritionJagiellonian University Medical CollegeCracowPoland
  2. 2.Department of Pediatric Gastroenterology and NutritionMedical University of WarsawWarsawPoland
  3. 3.Department of Gastroenterology Hepatology and Feeding DisordersChildren’s Memorial Health InstituteWarsawPoland
  4. 4.Pediatric and Pediatric Nursery Unit of The Pomeranian Medical University in SzczecinSzczecinPoland
  5. 5.Department of Pediatrics, Gastroenterology and NutritionMedical University of WroclawWroclawPoland
  6. 6.Department of Pediatrics and GastroenterologyArea Hospital in TorunTorunPoland
  7. 7.Pediatric Department with Children’s Cardiological SubunitHoly Spirit Hospital in SandomierzSandomierzPoland
  8. 8.Pediatric Department, Medical CollegeUniversity of RzeszówRzeszówPoland
  9. 9.Department of Pediatric Endoscopy and Gastrointestinal Function TestingCollegium Medicum Nicolaus Copernicus UniversityBydgoszczPoland

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