Solitary Rectal Ulcer Syndrome: A Case Report

Abstract

Pojedinačni ili multipli ulkusi mogu se pojaviti u bilo kojemu dijelu kolona i/ili u rektumu. Diferencijalna dijagnoza rektalnoga ulkusa uključuje: upalne bolesti crijeva, crijevne infekcije, urogenitalne bolesti, ulceracije uzrokovane lijekovima (na primjer, nesteroidnim protuupalnim lijekovima – NSAID-om), sindrom solitarnoga rektalnog ulkusa, sterkoralni ulkus, ishemički kolitis te rektalne neoplazme. Prikazan je slučaj 50-ogodišnje pacijentice kojoj je dijagnosticiran sindrom solitarnoga rektalnog ulkusa i koja se kontrolira posljednje četiri godine. S obzirom na anamnestičke podatke, endoskopski i patohistološki nalaz, uz kronični i benigni tijek bolesti, a bez znakova za postojanje drugih organskih bolesti, postavljena je dijagnoza sindroma solitarnoga rektalnog ulkusa. Dodatno je naveden terapijski postupak koji je uključivao konzervativno i medikamentozno liječenje te biofeedback vježbe uz literaturni prikaz predloženoga algoritma liječenja toga sindroma.Single or multiple ulcers may appear in any part of the colon and/or rectum. The differential diagnosis of a rectal ulcer includes: inflammatory bowel disease, intestinal infections, genitourinary infections, drug-induced ulcers (e.g. nonsteroidal anti-inflammatory drugs - NSAID), solitary rectal ulcer syndrome, stercoral ulcer, ischemic colitis and rectal neoplasm. The article presents a case of a 50-year-old patient who has been diagnosed with solitary rectal ulcer syndrome and has been observed for four years. On the basis of the medical case history, endoscopic and histological findings, the chronic and benign course of the disease, and no evidence of other organic diseases, the patient was diagnosed with solitary rectal ulcer syndrome. In addition, this article contains a description of the therapeutic procedure that included conservative and medical therapy together with biofeedback, and gives an overview of the literature dealing with the suggested treatment algorithm of this syndrome