Sebahattin Destek, MD1, Vahit Onur Gul, MD2. 1Tuzla Hospital General Surgery Dept., Istanbul/Turkey, 2Edremit Military Hospital General Surgery Dept
Aim: Solitary rectal ulcer syndrom (SRUS) was defined in 1829 by Cruveilheir for the first time, however its real existence was understood in 1969 after the clinical study of Madigan and Morson. By 35 % of the cases solitary ulcer and by 20 % multiple ulcer were present, whereas by 45 % no ulcer was present at all. It is met in the society by 0.00001. In general it is caused by reasons such as colonic intussusception, rectal prolapsus, pelvic floor disorders, traumatic enema, pelvic radiotherapy etc. It has indications like anal pain, bleeding, mucous defecation. No indication occurs by 25 % of the patients. The purpose of this study is to rewiev SRUS cases determined in our clinic.
Material-Method: The data of our six cases followed and treated in our clinic between the years 2011–2014 are evaluated retrospectively and discussed in this study.
Results: Two of the patients were male and four of them female and their average age was 48.3 (ages between 34-72). Major symptoms were constipation, tenesmus, bloody mucous defecation. Five patients were found to have anemia. One patient had a history of pelvic radiotherapy because of prostatic neoplasm. All patients had hemorrhoidal disease. Anal fistula was determined by one patient, and rectal prolapsus phase I was determined by another patient. Colonoscopy was applied to all patients and biopsies were taken from them. Multiple rectal ulcers were observed by one patient and solitary rectal ulcer by the others. Dietary arrangement, 5-aminosalicylic acid enemata and steroid treatment were given to the patients against constipation. Patients whose symptoms remitted were followed.
Conclusion: The patients are usually aged under 50. The first preference in the treatment is dietary arrangement and medical therapy and biofeedback therapy. In surgical treatment, the rate of failure is more than 50 %. Patients with chronic bleeding, uncontrollable pelvic pain and complete prolapsus would be candidates for surgical treatment.