2002
DOI: 10.1542/peds.110.6.e79
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A Rare and Often Unrecognized Cause of Hematochezia and Tenesmus in Childhood: Solitary Rectal Ulcer Syndrome

Abstract: ABSTRACT. Solitary rectal ulcer syndrome (SRUS) is an unusual disorder of childhood, which usually presents with rectal bleeding, mucous discharge, prolonged straining, tenesmus, and localized pain in the perineal area. After the first description by Cruveilhier, Madigan and Morson further detailed the clinical and pathologic features of SRUS in 1969. The pathogenesis of the syndrome is not well-understood. The postulated mechanism responsible for rectal prolapse in most cases seems to be excessive straining e… Show more

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Cited by 52 publications
(61 citation statements)
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“…[4,5,7,16,17,19,20] In previous reports, the macroscopic appearance of the hyperplastic type could not be distinguished from inflammatory polyp of the rectum or villous adenoma. [4,7,19] The characteristic histopathological findings of SRUS that provide differentiation from other diseases are obliteration with increased fibroblastic activity and presence of collagen deposition in the lamina propria, distortion of crypt architecture, lack of epithelial dysplasia, regenerative changes in crypt epithelium, and muscle fibers derived from muscularis mucosa in the surrounding tissue. [1,7,9,12,13,16,17] The diagnosis of SRUS is established by appraising symptoms together with endoscopic appearance and histopathologic findings.…”
Section: Discussionmentioning
confidence: 91%
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“…[4,5,7,16,17,19,20] In previous reports, the macroscopic appearance of the hyperplastic type could not be distinguished from inflammatory polyp of the rectum or villous adenoma. [4,7,19] The characteristic histopathological findings of SRUS that provide differentiation from other diseases are obliteration with increased fibroblastic activity and presence of collagen deposition in the lamina propria, distortion of crypt architecture, lack of epithelial dysplasia, regenerative changes in crypt epithelium, and muscle fibers derived from muscularis mucosa in the surrounding tissue. [1,7,9,12,13,16,17] The diagnosis of SRUS is established by appraising symptoms together with endoscopic appearance and histopathologic findings.…”
Section: Discussionmentioning
confidence: 91%
“…[3,7,8] Its etiology is still unclear. [4,[9][10][11] Previously, rectal mucosal ischemia and trauma were reported to be related in the etiology of SRUS. [7,[11][12][13] Defecation straining causes puborectalis relaxation allowing the stool passage in the normal situation.…”
Section: Discussionmentioning
confidence: 99%
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