Solitary rectal ulcer syndrome: Is it really a rare condition in children?
OBJECTIVE
To evaluate the clinicopathologic characteristics of the children with solitary rectal ulcer.


METHODS
Fifty-five children with a confirmed diagnosis of solitary rectal ulcer were studied in a period of 11 years from March 2003 to March 2014. All data were collected from the patients, their parents and medical records in the hospital.


RESULTS
From 55 studied patients, 41 were male (74.5%) and 14 female (25.5%). The mean age of the patients was 10.4 ± 3.7 years and the average time period from the beginning of symptoms to diagnosis of solitary rectal ulcer was 15.5 ± 11.2 mo. The most common clinical symptoms in our patients were rectal bleeding (n = 54, 98.2%) and straining during defecation or forceful defecation (n = 50, 90.9%). Other symptoms were as follows respectively: Sense of incomplete evacuation (n = 34, 61.8%), mucorrhea (n = 29, 52.7%), constipation (n = 14, 25.4%), tenesmus and cramping (n = 10, 18.2%), diarrhea (n = 9, 16.4%), and rectal pain (n = 5, 9.1%). The colonoscopic examination revealed 67.3% ulcer, 12.7% polypoid lesions, 10.9% erythema, 7.3% both polypoid lesions and ulcer, and 1.8% normal. Most of the lesions were in the rectosigmoid area at a distance of 4-6 cm from the anal margin. Finally, 69.8% of the patients recovered successfully with conservative, medical and surgical management.


CONCLUSIONS
The study revealed that solitary rectal ulcer is not so uncommon despite what was seen in previous studies. As the most common symptom was rectal bleeding, clinicians and pathologists should be familiar with this disorder and common symptoms in order to prevent its complications with early diagnosis.
Seyed Mohsen Dehghani, Maryam Bahmanyar, Bita Geramizadeh, Anahita Alizadeh, Mahmood Haghighat, Department of Pediatric Gastroenterology, Gastroenterohepatology Research Center, Shiraz Transplant Research Center, Nemazee Teaching Hospital, School of Medicine, Shiraz University of Medical Sciences, Shiraz 71937-11351, Iran.
Seyed Mohsen
SM
Dehghani
Seyed Mohsen Dehghani, Maryam Bahmanyar, Bita Geramizadeh, Anahita Alizadeh, Mahmood Haghighat, Department of Pediatric Gastroenterology, Gastroenterohepatology Research Center, Shiraz Transplant Research Center, Nemazee Teaching Hospital, School of Medicine, Shiraz University of Medical Sciences, Shiraz 71937-11351, Iran.
Maryam
M
Bahmanyar
Seyed Mohsen Dehghani, Maryam Bahmanyar, Bita Geramizadeh, Anahita Alizadeh, Mahmood Haghighat, Department of Pediatric Gastroenterology, Gastroenterohepatology Research Center, Shiraz Transplant Research Center, Nemazee Teaching Hospital, School of Medicine, Shiraz University of Medical Sciences, Shiraz 71937-11351, Iran.
Bita
B
Geramizadeh
Seyed Mohsen Dehghani, Maryam Bahmanyar, Bita Geramizadeh, Anahita Alizadeh, Mahmood Haghighat, Department of Pediatric Gastroenterology, Gastroenterohepatology Research Center, Shiraz Transplant Research Center, Nemazee Teaching Hospital, School of Medicine, Shiraz University of Medical Sciences, Shiraz 71937-11351, Iran.
Anahita
A
Alizadeh
Seyed Mohsen Dehghani, Maryam Bahmanyar, Bita Geramizadeh, Anahita Alizadeh, Mahmood Haghighat, Department of Pediatric Gastroenterology, Gastroenterohepatology Research Center, Shiraz Transplant Research Center, Nemazee Teaching Hospital, School of Medicine, Shiraz University of Medical Sciences, Shiraz 71937-11351, Iran.
Mahmood
M
Haghighat
Children; Colonoscopy; Forceful defecation; Rectal bleeding; Solitary ulcer