Surgical therapy for colitis cystica profunda and solitary rectal ulcer syndrome

被引:23
作者
David E. Beck
机构
[1] Ochsner Clinic Foundation,Department of Colon and Rectal Surgery
关键词
Intussusception; Rectal Prolapse; Transanal Excision; Solitary Rectal Ulcer Syndrome; Polyethylene Glycol Solution;
D O I
10.1007/s11938-002-0045-7
中图分类号
学科分类号
摘要
The initial treatment for patients with colitis cystica profunda is aimed at reeducation of bowel habits to avoid straining. Patients are instructed to spend the minimum time on the commode. A highfiber diet with bulk laxatives is recommended. If fiber does not work, polyethylene glycol solutions and surfaceactive stool softeners such as docusate sodium are tried. Conservative therapy resolves most symptoms. Biofeedback is offered to patients who fail dietary therapy.For patients with associated rectal prolapse, an operation designed to correct the intussusception is considered. For fullthickness prolapse (procidentia) a mucosal resection (Delorme) or perineal proctectomy (Altemeier) is recommended. Surgical treatment of internal (occult) prolapse is problematic. If attempted, a resection and suture rectopexy has the most support.In the absence of procidentia, transanal excision may be used in selected patients.If other measures fail, a mucosal sleeve resection with coloanal pullthrough or a diverting colostomy may be considered.
引用
收藏
页码:231 / 237
页数:6
相关论文
共 77 条
[1]  
Valenzuela M(1996)Colitis cystica profunda: imaging diagnosis and conservative treatment. Report of two cases Dis Colon Rectum 39 587-590
[2]  
MartinRuiz JL(1986)Gastritis cystica profunda Am J Gastroenterol 81 459-464
[3]  
AlvarezCienfuegos E(1989)Enteritis cystica profunda in a patient with Crohn’s disease Arch Pathol Lab Med 113 947-949
[4]  
Fonde EC(1957)Colitis cystica profunda J Pathol 73 33-42
[5]  
Rodning CB(1974)Colitis cystica profunda Am J Surg 127 749-752
[6]  
Alexis J(1982)Localized colitis cystica profunda Gastrointest Radiol 7 79-83
[7]  
Lubin J(1991)Transrectal US in the diagnosis of localized colitis cystica profunda Radiology 181 201-203
[8]  
Wallack M(2001)Rectal prolapse, rectal intussusception, rectocele, and solitary rectal ulcer syndrome Gastroenterol Clin North Am 30 199-222
[9]  
Goodall HB(1984)Treatment of solitary rectal ulcer syndrome with high fiber diet and abstention of straining at defecation Dig Dis Sci 29 1005-1008
[10]  
Sinclair IS(1981)Solitary rectal ulcer syndrome in Northern Ireland 1987–1980 Br J Surg 68 744-747