Technical Description and Results of Endoscopic Treatment of Various Solitary Rectal Ulcer Syndrome Pictures

Abstract

Solitary rectal ulcer syndrome is a rare disease producing different pictures, such as superficial ulcers, deep and large ulcers with elevated margins, and polypoid formations modifying the architecture of the rectum. The medical and surgical treatment usually suggested reduces symptoms but gives only partial results on the lesions. We have tried to treat this syndrome ulcers with Tissucol using the colonscope. We applied the product on small ulcers and both injected and applied it on large and elevated ulcers. Four-lumen catheter or sclerotherapy needles were used. Rapidly solidifying Tissucol was used for application and slowly solidifying Tissucol for injection. Two groups (1 and 2) of six patients each were treated both with dietetic and hygienic measures; group 1 was also treated with an application of Tissucol. After 15 days all six ulcers were healed in group 1 and none in group 2. After 1 year no ulcer was present in group 1 and 3/6 in group 2. Five patients with large elevated ulcers sometimes with multiple polypoid formations and with partial stenosis were treated as described above. Good results on symptoms were obtained in all patients. Complete healing was obtained in 3/5 patients and partial healing in 2/5 patients. However, the rectal lesions of these two patients were probably due to tuberculosis and endometriosis, rather than to solitary rectal ulcer syndrome.