title: Solitary Rectal Ulcer Syndrome in Children: A Case Series Study.
abstract: Information on solitary rectal ulcer syndrome (SRUS) in children is limited and based on case reports only. This study was undertaken with the objective of describing the clinical history, symptoms, diagnostic work-up, and treatment of a large case series of pediatric patients with SRUS. The study was multi-center and retrospective. All pediatric endoscopists in Poland were invited to participate in the study and were asked to look through their endoscopic databases to identify SRUS cases from the last 10 years. The charts of SRUS patients were reviewed with respect to demographic data, and endoscopic and histological findings. Additionally, treatment methods and outcomes were assessed. In total, 31 patients (18 males, mean age of 13 years, range 5-18 years) were included in the study. All patients reported rectal bleeding. Other common symptoms included: abdominal pain (64.5%), perianal pain (54.8%), and passage of mucus (51.6%). The diagnostic work-up lasted from 1 to 48 months. Colonoscopic findings revealed rectal ulceration in 96.8% of patients. Therapeutic approaches included: high fiber diet (64.5%), laxatives (54.8%), topical corticosteroids (63.3%), 5-aminosalicylates administered orally and topically (29.1% and 96.8%, respectively), sucralfate (9.7%), and a biofeedback training (6.6%). Endoscopic argon plasma coagulation was performed in 2 patients and surgical intervention was necessary in 4 of them. Treatment was unsuccessful in 36% of patients. The findings of this study indicate that SRUS is rare in pediatric population, its diagnosis may be considerably delayed, and the treatment applied is often ineffective.
authors.affiliation: Department of Pediatric, Gastroenterology and Nutrition, Jagiellonian University Medical College, Cracow, Poland.
authors.forename: K
authors.initials: K
authors.lastname: Kowalska-Duplaga
authors.affiliation: Department of Pediatric Gastroenterology and Nutrition, Medical University of Warsaw, Warsaw, Poland. ilazowska@gmail.com.
authors.forename: I
authors.initials: I
authors.lastname: Lazowska-Przeorek
authors.affiliation: Department of Pediatric Gastroenterology and Nutrition, Medical University of Warsaw, Warsaw, Poland.
authors.forename: K
authors.initials: K
authors.lastname: Karolewska-Bochenek
authors.affiliation: Department of Gastroenterology Hepatology and Feeding Disorders, Children's Memorial Health Institute, Warsaw, Poland.
authors.forename: M
authors.initials: M
authors.lastname: Woynarowski
authors.affiliation: Pediatric and Pediatric Nursery Unit of The Pomeranian Medical University in Szczecin, Szczecin, Poland.
authors.forename: G
authors.initials: G
authors.lastname: Czaja-Bulsa
authors.affiliation: Department of Pediatrics, Gastroenterology and Nutrition, Medical University of Wroclaw, Wroclaw, Poland.
authors.forename: A
authors.initials: A
authors.lastname: Stawarski
authors.affiliation: Department of Pediatric, Gastroenterology and Nutrition, Jagiellonian University Medical College, Cracow, Poland.
authors.forename: S
authors.initials: S
authors.lastname: Pieczarkowski
authors.affiliation: Department of Pediatrics and Gastroenterology, Area Hospital in Torun, Torun, Poland.
authors.forename: E
authors.initials: E
authors.lastname: Hapyn
authors.affiliation: Pediatric Department with Children's Cardiological Subunit, Holy Spirit Hospital in Sandomierz, Sandomierz, Poland.
authors.forename: J
authors.initials: J
authors.lastname: Jozefczuk
authors.affiliation: Pediatric Department, Medical College, University of Rzeszów, Rzeszów, Poland.
authors.forename: B
authors.initials: B
authors.lastname: Korczowski
authors.affiliation: Department of Pediatric Endoscopy and Gastrointestinal Function Testing, Collegium Medicum Nicolaus Copernicus University, Bydgoszcz, Poland.
authors.forename: A
authors.initials: A
authors.lastname: Szaflarska-Poplawska
authors.affiliation: Department of Pediatric Gastroenterology and Nutrition, Medical University of Warsaw, Warsaw, Poland.
authors.forename: A
authors.initials: A
authors.lastname: Banaszkiewicz
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D006471:Gastrointestinal Hemorrhage; D006801:Humans; D008297:Male; D011044:Poland; D012002:Rectal Diseases / Q000175:diagnosis* / Q000628:therapy; D012189:Retrospective Studies; D014456:Ulcer / Q000175:diagnosis* / Q000628:therapy
keywords: Children; Rectal bleeding; Solitary rectal ulcer syndrome