SOLITARY ULCER OF THE RECTUM:A CASE REPORT AND A REVIEW OF LITERATURES WITH A SPECIAL REFERENCE TO ITS PATHOGENESIS

概要

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Two cases of solitary ulcer of the rectum are presented. Reviewing the literatures, the following conclusions are obtained. 1) Thirty-two cases of SUR have been reported in Japan. 2) Sex ratio, male to female, is 2: 1. Average age of male and female is 49.1 and 47.7, respectively. 3) A single ulcer is seen in 72%. The ulcers located on anterior wall in 65%. 4) Bleeding on defecation is the most common chief complaint. 5) Five out of 32 patients had psychic disturbances. 6) The pathogenesis of SUR remains unknown. Many investigators have made posturates in regard to its pathogenesis. The authors consider Rutter's postulation, namely, mucosal prolapse caused by excessive strain at stool is most reasonable. This postulation, however, can not explain the location of ulcers on lateral and/or posterior wall. 7) Endoscopy is the most reliable means for the diagnosis of SUR. 8) Drugs, such as steroid and salazopyrin, have no efficacy to SUR. 9) Indication of operation must be carefully decided, since functional disturbance of anal sphincter frequently occurrs as a complication of the operation.
社団法人日本消化器内視鏡学会の論文