Gastrointestinal Therapeutics

Biography

Biography: Vahit Onur Gul

Abstract

Purpose: Solitary rectal ulcer syndrom (SRUS) arises with one or more ulcers at rectum or with rectal wall thickening. It was defined in 1830 by Cruveilheir for the first time. It is met 1 over 100 000 in the society. SRUS generally shows up with rectal bleeding, pain, mucous defecation, difficulty in rectal evacuation. Rectal bleeding is the major symptom and occurs by 90 % of the patients. Since rectal prolapsus is present by patients with SRUS, in the studies performed it was shown that pelvic floor muscles were contracted discordantly and blood flow was decreased in the mucosa. One of our cases with rectal prolapsus and SRUS is presented in this presentation.\\r\\n\\r\\nCase: The patient was 45 years old and female and had the symptoms constipation, bleeding during defecation, tenesmus since two years. The patient had a medical history of idiopathic prolactinoma and hashimoto thyroiditis. The patient was anemic. In her gastroscopy, reflux esophagitis, hiatal hernia, helicobacter pylori (+) pangastritis were determined. In her colonoscopy, grade III hemorrhoidal disease, at upper rectum between 10-15 cm ulcer at rectum mucosa, dark coloured areas at cecum mucosa were determined. In the pathological examination, SRUS at rectum and melanosis coli at cecum were diagnosed. No pathology was observed in the enterography. External rectal prolapsus was determined in the digital defecography. Laparoscopic ripstein operation was applied to the patient. In the colonoscopy of the patient after one year, it was observed that SRUS at rectum was cured. \\r\\n\\r\\nConclusion: SRUS should be differentiated from other diseases causing mucosal ulceration. Medical or surgical treatment methods can be used according to the underlying cause. The priority in the treatment has the medical treatment. However surgical restoration could be prioritized by patients having coexisting rectal prolapsus.\\\\r\\\\n