Solitary Rectal Ulcer Syndrome: Uncommon Cause of Rectal Bleeding in Children

Rectal polyp and hemorrhoids are common causes of bleeding per rectum in pediatric age group.However, there are some other causes which should be considered in differential diagnosis. We haveacquainted a case of rectal bleeding due to solitary rectal ulcer in a child of 10 year. Colonoscopicexamination was required for diagnosis as proctoscopic examination and digital rectal examinationmissed the diagnosis, probably due to poor co-operation by the patient and rare nature of the disease.Although well recognized in the adult population, the pediatric experience with this condition islimited.Key word: children, rectal bleeding, solitary rectal ulcer

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A report of 112 cases of solitary rectal ulcer syndrome from Iran

Open Medicine ◽

10.2478/s11536-009-0006-9 ◽

2009 ◽

Vol 4 (1) ◽

pp. 49-53 ◽

Cited By ~ 2

Author(s):

Saeed Derakhshani ◽

Mohsen Pakzad ◽

Mohammad Vafaie ◽

Shirin Tehrani-Tarighat ◽

Mohammad Abdollahi

Keyword(s):

Rectal Bleeding ◽

Obstructed Defecation ◽

Final Diagnosis ◽

Rectal Polyp ◽

Common Symptom ◽

Rectal Ulcer ◽

Solitary Rectal Ulcer ◽

Solitary Rectal Ulcer Syndrome ◽

Clinical Presentations ◽

Rectal Polyps

AbstractSolitary rectal ulcer syndrome (SRUS) is a syndrome with symptoms such as rectal bleeding, obstructed defecation, straining at stool and incomplete evacuation, and rectal polyps. In the present study, the clinical features of SRUS among Iranian patients is reviewed. Records of 112 patients diagnosed with SRUS between 1997 and 2007 admitted to a special coloproctology clinic have been analyzed retrospectively. Of 112 patients with SRUS, 61 were male (54.4%) and 51 female (45.6%) with a mean age of 32.2 years (range, 16–64 years). The mean interval between onset of symptoms and final diagnosis of SRUS was 3.8 years (range, 1–14 years). Rectal bleeding (67%) was the most common symptom in both genders, while a feeling of fullness was the least common symptom, observed only in one woman (2%). Incontinence was observed in 4 women (7.8%) and 3 men (4.9%), comprising 6.25% of the total clinical presentations. There were 38 patients (33.9%) with mucosal prolapse and 2 patients (1.8%) with total rectal prolapse. In conclusion, rectal bleeding in the presence of constipation or diarrhea is the main sign for diagnosis of SRUS. This syndrome is usually misdiagnosed; it is frequently confused with inflammatory bowel disease (IBD) because the rectal macroscopic and microscopic lesions and true polyps of rectum are similar. We suggest that most of patients who are treating for IBD and true polyps without any response are suffering from SRUS. Regarding misdiagnosis between SRUS and IBD or rectal polyp, the exact prevalence of SRUS has been mistakenly underestimated.

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Solitary Rectal Ulcer Syndrome in a 12-Year Bangladeshi Boy: an Unusual Cause of Rectal Bleeding

KYAMC Journal ◽

10.3329/kyamcj.v11i2.48425 ◽

2020 ◽

Vol 11 (2) ◽

pp. 104-107

Author(s):

Md Benzamin ◽

Kaniz Fathema ◽

Dipawnita Saha ◽

Bodhrun Nahar ◽

Sharmin Akther ◽

...

Keyword(s):

Ulcerative Colitis ◽

Inflammatory Bowel Disease ◽

Rectal Bleeding ◽

Bowel Disease ◽

Clinical Condition ◽

Rectal Polyp ◽

Rectal Ulcer ◽

Solitary Rectal Ulcer ◽

Solitary Rectal Ulcer Syndrome ◽

Inflammatory Bowel

Solitary rectal ulcer syndrome (SRUS) is an uncommon cause of per rectal bleeding in children. Due to it's wide variety of presentation and rarity, it is frequently misdiagnosed as other clinical condition like inflammatory bowel disease, rectal polyp, amoebiasis or malignancy. Here we presenting a case initially misdiagnosed as ulcerative colitis, latter after thorough evaluation diagnosed as a case of SRUS. KYAMC Journal Vol. 11, No.-2, July 2020, Page 104-107

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Solitary Rectal Ulcer Syndrome in Childhood: A Rare, Benign, and Probably Misdiagnosed Cause of Rectal Bleeding. Report of Three Cases

Diseases of the Colon & Rectum ◽

10.1007/s10350-006-0720-1 ◽

2007 ◽

Vol 50 (4) ◽

pp. 534-539 ◽

Cited By ~ 12

Author(s):

Javier Martín de Carpi ◽

Pere Vilar ◽

Vicente Varea

Keyword(s):

Rectal Bleeding ◽

Rectal Ulcer ◽

Solitary Rectal Ulcer ◽

Solitary Rectal Ulcer Syndrome

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Solitary Rectal Ulcer Syndrome in Children

The Journal of Pediatric Academy ◽

10.51271/jpea-2021-0103 ◽

2021 ◽

pp. 22-26

Author(s):

Duran Arslan ◽

Buket Daldaban Sarıca

Keyword(s):

Abdominal Pain ◽

Rectal Bleeding ◽

Demographic Data ◽

Endoscopic Examination ◽

Response To Treatment ◽

Common Symptom ◽

Rectal Ulcer ◽

Solitary Rectal Ulcer ◽

Chi Square ◽

Solitary Rectal Ulcer Syndrome

To describe clinical features, demographic data, and complications of the patients with SRUS, which is a rare cause of rectal bleeding in children. Eleven patients diagnosed with Solitary Rectal Ulcer Syndrome (SRUS) were evaluated. The patients assessed by colonoscopy and the biopsies were investigated. The data evaluated in SPSS Program. The exact Method of the Chi-square test was used to compare groups according to qualitative variables. P <0.05 value was considered statistically significant. The most common symptom of the patients was rectal bleeding followed by abdominal pain and constipation. Lesions were mostly ulcerative in the endoscopic examination. There was a statistically significant relationship between the admission symptom and the response to treatment. Patients with abdominal pain and rectal bleeding had poor responses to treatment. In conclusion, SRUS is not uncommon than is thought in pediatric patients with the symptoms of rectal bleeding and constipation. SRUS should be considered in patients with or without rectal prolapse, with any complaints of any lesions in the rectum, hematochezia, and tenesmus.

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Role of colonoscopy in haemorrhoids with other colorectal disorders

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20191327 ◽

2019 ◽

Vol 7 (4) ◽

pp. 1212

Author(s):

Tariq Ahmed Mala ◽

Syeed Rayees Ahmad ◽

Shahid Amin Malla

Keyword(s):

Rectal Bleeding ◽

Rectal Wall ◽

Digital Rectal Examination ◽

Rectal Mucosa ◽

Rectal Ulcer ◽

Solitary Rectal Ulcer ◽

Bleeding Per Rectum ◽

Inflammatory Bowel ◽

Time Of Presentation

Background: Haemorrhoids are the enlargement or engorgement of the normal fibrovascular anal cushions. These fibrovascular cushions lose their attachment to the underlying rectal wall and lead to prolapse with repeated straining over time, thinning of rectal mucosa and subsequent bleeding. The objective of the present endeavour was to study the prevalence of associated colorectal lesions like colonic carcinoma, diverticular disease, inflammatory bowel disease which present the rectal bleeding and role of colonoscopy in these lesionsMethods: This study was conducted in hundred fifty patients presenting with bleeding and haemorrhoids were analyzed. All patients were examined locally and endoscopically. All significant endoscopic findings (diverticuli, polyps, cancer, angiodysplasia and varices or colitis) were recorded.Results: Majority of patients were males (102), accounting for (68 percent). The main symptom at the time of presentation was rectal bleeding (90 percent). The digital rectal examination was normal in 114 patients. The commonest finding on proctoscopy examination was haemorrhoids. Colonoscopy showed haemorrhoids in maximum patients (147 percent). The associate lesions with altered bowel habits were growth in 12, worm in 6, solitary rectal ulcer in 3, pancolitis in 3.Conclusions: It can be concluded that in the present study colonoscopy revealed a high proportion of colorectal pathologies with haemorrhoids presenting with bleeding per rectum. Colonoscopy thus proved to be very useful procedure in patients with haemorrhoids especially in elderly.

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5-ASA Therapy in Solitary Rectal Ulcer Syndrome. Report of Three Patients

Canadian Journal of Gastroenterology ◽

10.1155/1988/841649 ◽

1988 ◽

Vol 2 (1) ◽

pp. 18-21 ◽

Cited By ~ 1

Author(s):

D.A. Malatjalian ◽

C.N. Williams

Keyword(s):

Rectal Bleeding ◽

Rare Condition ◽

Complete Healing ◽

Rectal Ulcer ◽

Solitary Rectal Ulcer ◽

Solitary Rectal Ulcer Syndrome ◽

History Of ◽

Recurrent Ulcers ◽

Syndrome Report

Solitary rectal ulcer syndrome (SRUS) is a rare condition which presents typically with a long standing history of constipation, straining, rectal bleeding, mucus discharge and pain on defecation. Three cases of SRUS arc discussed which were all successfully treated with 5-ASA enemas. Complete healing occurred within a few weeks and recurrent ulcers healed just as readily with renewed therapy.

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An Unusual Cause of Rectal Stenosis

Case Reports in Gastroenterology ◽

10.1159/000448065 ◽

2016 ◽

Vol 10 (2) ◽

pp. 406-409

Author(s):

Maja Gruber ◽

Ida Füglistaler ◽

Andreas Zettel ◽

Mark Fox ◽

Michael Manz

Keyword(s):

Rectal Prolapse ◽

Rectal Bleeding ◽

Benign Disease ◽

Unusual Presentation ◽

Rectal Ulcer ◽

Rectal Stenosis ◽

Solitary Rectal Ulcer ◽

Solitary Rectal Ulcer Syndrome ◽

Endoscopic Findings ◽

Mucous Discharge

Solitary rectal ulcer syndrome (SRUS) is a benign disease that is often misdiagnosed. It is characterized by a combination of symptoms, endoscopic findings and histology. Patients present with constipation, rectal bleeding, mucous discharge, pain and a sensation of incomplete defecation. There are many different manifestations of this disease, with or without rectal prolapse. We report an unusual presentation of SRUS as a circular stenosis in a middle-aged male.

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