title: Solitary rectal ulcer syndrome in children and adolescents.
abstract: OBJECTIVE
  The aim of this study was to describe the presenting symptoms, endoscopic and histologic findings, and clinical courses of pediatric patients diagnosed with solitary rectal ulcer syndrome (SRUS).
  
  
  METHODS
  We describe 15 cases of SRUS diagnosed at our institution during a 13-year period. Cases were identified by review of a pathology database and chart review and confirmed by review of biopsies. Data were collected by retrospective chart review.
  
  
  RESULTS
  Presenting symptoms were consistent but nonspecific, most commonly including blood in stools, diarrhea alternating with constipation, and abdominal/perianal pain. Fourteen of 15 patients had normal hemoglobin/hematocrit, erythrocyte sedimentation rate, and albumin at diagnosis. Endoscopic findings, all limited to the distal rectum, ranged from erythema to ulceration and polypoid lesions. Histology revealed characteristic findings. Stool softeners and mesalamine suppositories improved symptoms, but relapse was common.
  
  
  CONCLUSIONS
  SRUS in children presents with nonspecific symptoms and endoscopic findings. Clinical suspicion is required, and diagnosis requires histologic confirmation. Response to present treatments is variable.
authors.affiliation: Department of Pediatrics, University of California, San Francisco, CA 94143-0136, USA. peritoe@peds.ucsf.edu
authors.forename: Emily R
authors.initials: ER
authors.lastname: Perito
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Mileti
authors.forename: Deepal H
authors.initials: DH
authors.lastname: Dalal
authors.forename: Soo-Jin
authors.initials: SJ
authors.lastname: Cho
authors.forename: Linda D
authors.initials: LD
authors.lastname: Ferrell
authors.forename: Marjorie
authors.initials: M
authors.lastname: McCracken
authors.forename: Melvin B
authors.initials: MB
authors.lastname: Heyman
mesh_terms: D000293:Adolescent; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000150:complications; D054368:Laxatives / Q000627:therapeutic use; D008297:Male; D019804:Mesalamine / Q000627:therapeutic use; D011351:Proctoscopy; D012002:Rectal Diseases / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy; D012008:Recurrence; D012189:Retrospective Studies; D013488:Suppositories / Q000627:therapeutic use; D013577:Syndrome; D016896:Treatment Outcome; D014456:Ulcer / Q000150:complications / Q000175:diagnosis*
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D054368:Laxatives; D013488:Suppositories; D019804:Mesalamine
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