Gastrointestinal Radiology > Procedures > Defecography > Defecography (16)

Defecography (cont.)

Anorectal Disorders Exhibiting Pathologic Defecograms (cont.)

Solitary Rectal Ulcer Syndrome
  • The solitary rectal ulcer syndrome is a chronic, benign condition, mainly affecting young adults and characterized by the passage of blood and mucus, rectal pain, prolonged straining, and, often, the feeling of anal blockage.
  • The rectal lesion consists of one or more benign ulcers or erosions in the mucosa of the anterior wall of the distal rectum.
  • The diagnosis is usually established by sigmoidoscopy and biopsy.
  • Barium enema, especially double contrast barium enema, may demonstrate signs of thickened rectal folds, rectal spasm, granularity, ulceration, and pseudopolypoid or pseudotumoral changes.
  • The most likely etiology is mechanical injury to the mucosa from repeated rectal intussusception, self-digitation, or instrumentation.
  • In one study of 43 patients with solitary rectal ulcer syndrome, defecography demonstrated rectal intussusception in 79%. Of these, 44% had external rectal prolapse. The partial causative role of rectal intussusception is also supported by the healing of the rectal lesions after proctopexy.
  • Other findings which may be observed during defecography include rectocele, rectal prolapse, abnormal perineal descent, and puborectalis muscle dysfunction.

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