直腸の粘膜脱症候群 (mucosal prolapse syndrome) の 1 例

概要

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A 12-year-old boy was admitted with complaints of anal bleeding and anorectal pain. Barium enema and colonoscopic examination revealed polypoid lesions on both lateral walls of the lower rectum. The polypoid lesions (2.3×0.9×0.7cm and 3.0×1.2×0.9cm in size) were locally resected by transanal approach. Microscopic examination of the lesion revealed marked fibromuscular hyperplasia of the lamina propria, and the histological diagnosis was mucosal prolapse syndrome (MPS). The patient was instructed to avoid straining at defecation, and he has been asymptomatic for 12 months after the operation. MPS is a rare condition in childhood, and only 16 pediatric cases (including solitary ulcer syndrome of the rectum) are reported in Japan including this case. Twelve of the 16 cases are of boys, and polypoid lesions are reported in all cases. The treatment of MPS is not established. At present, the best treatment is local resection of large polypoid lesions and of ulcers, and instruction to avoid straining.
日本小児外科学会の論文
1990-12-20