Subacute ischaemic proctitis: a rare condition requiring extensive rectal surgery.
Subacute ischaemic proctitis is a rare condition. We describe the case of a 60-year-old male patient who developed, after aortic aneurysm repair, a transient ischaemic colitis that totally healed without sequelae. He eventually developed symptoms of severe proctitis. Investigations identified a stenosis of the mid rectum, while the upper rectum was inflammatory. On angiogram, there was a poor blood flow through the Riolan's arcade and a stenosis of the proximal aorto-graft anastomosis. Diagnosis of subacute ischaemic proctitis due to poor blood supply through the internal iliac arteries was made. Anti-inflammatory drugs and dilations were inefficient. A subtotal proctectomy with low colorectal anastomosis was required. On pathological specimen, the lesions were strongly suggestive of an ischaemic process. The patient had an excellent recovery and was asymptomatic 8 months after the operation.
Detry
R
R
Department of Digestive Surgery, University Hospital St-Luc, UCL-Brussels Medical School, Belgium.
Ladah
E Z
EZ
Kartheuser
A
A
Verhelst
R
R
D017544:Aortic Aneurysm, Abdominal / Q000601:surgery*; D006801:Humans; D007511:Ischemia / Q000209:etiology / Q000473:pathology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011349:Proctitis / Q000209:etiology / Q000473:pathology / Q000601:surgery; D012007:Rectum / Q000098:blood supply* / Q000473:pathology / Q000601:surgery