Solitary ulcer of the rectum: a syndrome
Melange, M.; Vanheuverzwyn, R.; Mahieu, P.; Detry, R.; Heuchamps, Y.; Haot, J.; Dive, C.
Acta Gastro-Enterologica Belgica 48(2): 140-147
1985
ISSN/ISBN: 1784-3227 PMID: 4082873 Document Number: 5762
The solitary ulcer of the rectum is characterized by a benign proctitis, without ulcer or with one (or more) ulcer (s), whose histological aspect suggests a traumatic origin. This study is based an 28 observations, performed over a period of 10 years and emphasizes the endoscopical and histological criteria of the disease. The clinical examination, less sensitive than the defecography, has revealed a rectal prolapse in 21 cases (out of the 28) : this might be the origin of the syndrome. The anorectal manometry and the electromyography measure the indirect effects of the rectal prolapse (hypotony of the anal sphincter, denervation). The electromyography is also helpful in detecting the persistent hypertony of the puborectal muscle during defecation (in our experience this abnormality was rare). The medical treatment is indicated in the minor forms of solitary ulcer of the rectum or when the rectal prolapse cannot be proven objectively. In 8 patients a rectopexy was performed : the symptoms disappeared and the macroscopic aspect of the rectal mucosa returned to normal.
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