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Clinical Spectrum of Solitary Rectal Ulcer in Children Presenting With Per-Rectal Bleed.

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eMediNexus    23 May 2018

The objective of a study published in the Journal of Ayub Medical College was to determine the frequency and clinical spectrum of solitary rectal ulcer in children with bleeding per rectum. This study was conducted on 187 children presenting with per-rectal bleeding who underwent colonoscopy. Demographic and presenting clinical features as well as colonoscopy and histopathology findings were recorded. It was observed that out of 187 children with bleeding per rectum, 11.23% were diagnosed with solitary rectal ulcer. This group comprised 71.43% and females and 28.57% males with an age range 8-12 years. Additionally, 66.7% children with mucus in stool and 57.1% with constipation and 47.6% with tenesmus. Furthermore, colonoscopic findings exhibited solitary erythmatous ulcerative lesion in 38.09% children; multiple ulcerative lesions in colon in 28.57%; multiple ulcerative lesions in rectum in 23.81%; and polypoidal growth in colon and hyperaemic rectal mucosa in 4.76% each. Histopathological findings were consistent with solitary rectal ulcer syndrome (SRUS) in all the cases. Hence, it was concluded that the frequency of SRUS was high in patients with per-rectal bleed. Mucus in stool, constipation and tenesmus are the most common clinical presentations, while colonoscopic and histopathological findings were helpful in the confirmation of the underlying aetiology.

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