1/14. Rectal strictures following abdominal aortic aneurysm surgery.Rectal stricture formation is a rare complication of aortic aneurysm repair. Two case are described here. A combination of hypotension, a compromised internal iliac circulation and poor collateral supply following inferior mesenteric artery ligation can result in acute ischaemic proctitis--an infrequently described clinical entity. Ulceration and necrosis are the sequelae of prolonged ischaemia and fibrous stricture formation may result. One patient responded to dilatation and posterior mid-rectal myotomy; the other failed to respond to conservative measures and eventually had an end colostomy fashioned following intractable symptoms.- - - - - - - - - - ranking = 1keywords = proctitis (Clic here for more details about this article) |
2/14. Solitary rectal ulcer syndrome presenting with rectal prolapse, severe mucorrhea and eroded polypoid hyperplasia: case report and review of the literature.A case of solitary rectal ulcer syndrome in a 36-year-old woman presenting with severe, persistent mucorrhea and eroded polypoid hyperplasia as the predominant clinical features, who was ultimately noted to have symptoms of rectal prolapse, is presented. Endoscopically, she had multiple (50 to 60) small, whitish polypoid lesions in the rectum that were initially misinterpreted as being a carpeted villous adenoma, juvenile polyposis or atypical proctitis. The lesions were treated with argon plasma coagulation with resolution, but a solitary rectal ulcer developed. The patient then admitted to a history of massive rectal prolapse over the preceding six months and underwent surgical treatment. Severe mucorrhea as the presenting feature and the presence of multiple polypoid lesions consistent with a histological diagnosis of eroded polypoid hyperplasia make the present case unique.- - - - - - - - - - ranking = 1keywords = proctitis (Clic here for more details about this article) |
3/14. Rectal ulceration as a result of prostatic brachytherapy: a new clinical problem: report of three cases.INTRODUCTION: prostate cancer is the most common cancer of males in the united states. One treatment modality for localized prostate cancer is brachytherapy, the implantation of radioactive seeds directly into the prostate. Although this is an effective treatment option, significant complications can result. More commonly these complications involve the genitourinary tract, but radiation proctitis is a well-recognized, less common complication. A specific complication of brachytherapy, the development of a rectal ulcer is not well recognized. The clinical course of this complication and results of treatment options are unknown. methods: Three cases of rectal ulceration as a consequence of prostatic brachyradiotherapy are presented, and the presumed course of disease and treatment options is discussed. RESULTS: Two patients were initially treated with local advancement flaps that both failed. These patients developed rectourethral fistulas. One patient was treated with diverting colostomy and suprapubic urinary diversion. The second underwent proctectomy and coloanal anastomosis. This also failed after multiple attempts to treat perianastomotic fistulas. The third patient was treated endoscopically for bleeding and has had no further interventions. CONCLUSION: In the small percentage of patients who develop rectal ulcerations from prostatic brachyradiotherapy, local medical or surgical treatments will often result in failure. They also may contribute to the eventual development of rectourethral fistulas, the likely natural progression of this disease. These fistulas should be treated with both urinary and fecal diversion. Earlier stages of ulceration may be treated with rectal resection and reconstruction, but selection criteria for these procedures have yet to be determined.- - - - - - - - - - ranking = 1keywords = proctitis (Clic here for more details about this article) |
4/14. Therapeutic regimens for anorectal gonococcal infection in males.Anorectal gonococcal infection is particularly prevalent in women and homosexual men. Although the currently recommended public health Service therapeutic regimens for uncomplicated gonorrhea appear to be effective also for anorectal gonorrhea in women, their efficacy for anorectal infection in men has not been adequately evaluated. We report a case of gonococcal proctitis in a homosexual man that did not respond to therapy with ampicillin plus probenecid and tetracycline, but subsequently responded to spectinomycin therapy. Currently available therapeutic regimens for anorectal gonococcal infection in males are reviewed.- - - - - - - - - - ranking = 1keywords = proctitis (Clic here for more details about this article) |
5/14. Anorectal lymphogranuloma venereum in a Melbourne man.We report the first case of anorectal lymphogranuloma venereum (LGV) in a man who has sex with men (MSM) in australia in the setting of the recent emergence of LGV among MSM in europe and the USA. A 33-year-old man presented with a 2 month history of mild external anal discomfort. He gave a history of unprotected receptive and insertive anal intercourse with one partner in europe during the preceding 6 months. No symptoms suggested proctitis and examination revealed two small anal fissures. An anal swab was positive for chlamydia trachomatis; investigation for other STIs including hiv were negative. On review 6 days later, he was investigated and treated presumptively for LGV. The LGV diagnosis was confirmed by identifying the L2 serovar of C. trachomatis using a genotype test on the original anal specimen. This case is in keeping with the more recent reports of LGV from europe, and has demonstrated the need for a high index of suspicion for asymptomatic or minimally symptomatic anorectal LGV.- - - - - - - - - - ranking = 1keywords = proctitis (Clic here for more details about this article) |
6/14. cytomegalovirus primo-infection in a patient with idiopathic proctitis.A young heterosexual man, suffering from a low-grade, idiopathic proctitis, who developed severe rectal ulcerations at the time of a primary cytomegalovirus (CMV) infection is described. CMV was cultured from the rectum on two occasions. Sero-conversion and the appearance of a specific IgM antibody response to CMV were documented, suggesting that this was a case of a primo-infection by CMV, and not one of reactivation of latent CMV infection.- - - - - - - - - - ranking = 5keywords = proctitis (Clic here for more details about this article) |
7/14. Heterotopic gastric mucosa of the rectum. A rare cause of rectal bleeding.We studied a patient with rectal gastric heterotopia and found nine reported cases of this rare disease in the literature. Symptoms include proctitis and rectal bleeding. Heterotopic gastric epithelium may be developmental or acquired, depending on the type of mucosal epithelium involved. Since this type of lesion can occur anywhere in the alimentary tract and even in multiple sites, long-term follow-up is recommended. The diagnosis is made by biopsy and pathologic examination. The treatment consists of total local excision. sigmoidoscopy, colonoscopy, and technetium scanning can be used as adjunctive aids in diagnosing secondary sites of gastric heterotopia.- - - - - - - - - - ranking = 1keywords = proctitis (Clic here for more details about this article) |
8/14. Benign (solitary) ulcer of the rectum -- another cause for rectal stricture.Benign rectal ulcer syndrome is an uncommon cause of lower gastrointestinal bleeding. patients may present with mild, often recurrent, rectal bleeding frequently ascribed to hemorrhoids. barium enema may be normal during the early, nonulcerative phase of proctitis. Single (or multiple) ulcers with or without rectal stricture are the hallmarks of the radiographic diagnosis. Radiologic demonstration of the ulcer(s) is not required, however, for the diagnosis. Benign rectal ulcer should be included in the differential diagnosis of benign-appearing rectal strictures.- - - - - - - - - - ranking = 1keywords = proctitis (Clic here for more details about this article) |
9/14. Staphylococcal pelvic and rectal infection in a neonate.An infant with neonatal staphylococcal infection had evidence of pelvic inflammation, peritonitis and proctitis which resulted in narrowing of the rectosigmoid, uterectasis, pyelocaliectasis, and partial obstruction of the inferior vena cava. Appropriate treatment resulted in resolution of these findings.- - - - - - - - - - ranking = 1keywords = proctitis (Clic here for more details about this article) |
10/14. Solitary rectal ulcer syndrome.We report three cases of solitary rectal ulcer syndrome (SRUS). The diagnosis was established according to histopathologic criteria. But, the initial clinical diagnosis was carcinoma, non-specific ulcer and localized proctitis respectively. SRUS is considered as one of functional disorder in pelvic floor which might go underdiagnosed due to unfamiliar concept in korea. So we should consider SRUS to be one of the differential diagnosis in cases of complaining anorectal symptoms.- - - - - - - - - - ranking = 1keywords = proctitis (Clic here for more details about this article) |
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