Balloon dilation and intralesional steroid for benign rectal stricture management in a cat

Abstract

A 4-year-old castrated male domestic shorthair presented for 1 week of constipation and tenesmus. A rectal stricture had been diagnosed 8 months prior at the time of adoption and the cat had been successfully managed with stool softeners until presentation. A complete diagnostic work-up failed to reveal an underlying etiology for the stricture and colonoscopy was performed. Endoscopic biopsies of the stricture revealed benign non-specific inflammatory changes. Balloon dilation of the rectal stricture was performed during the initial colonoscopy and 3 and 9 days later. Triamcinolone acetonide was injected into the stricture site with endoscopic guidance during the third dilation procedure. The patient has been monitored for over 27 months; follow-up indicates no signs of tenesmus and repeated rectal examinations reveal no stricture recurrence. This case report demonstrates that endoscopic balloon dilation with intralesional steroid injection represented a minimally invasive and effective option for the treatment of a benign rectal stricture in this cat, and deserves further prospective investigation.

Treatment of inflammatory rectal strictures by digital bougienage: a retrospective study of nine cases

“…) and the other similar to our cases (Chavkin et al . ). Our study describes five cases of rectal stricture associated with colitis in cats.…”

“…, Chavkin et al . ). In kittens and puppies, benign rectal stricture has to be differentiated from type I atresia ani , which is a congenital disorder.…”

“…, Chavkin et al . ). This protocol was also used in a report of type I atresia ani in five kittens and a puppy (Tomsa et al .…”

Balloon dilation of a congenital rectal stricture in a 16‐week‐old kitten

“…Type II and type III atresia ani with rectovaginal or rectocutaneous fistulation is more commonly reported and various surgical techniques have been described for management 3–6. Benign/inflammatory rectal strictures appear more commonly in the literature but are still rare with only seven cases reported to date 7–9…”

“…Both surgical resection and dilation procedures have been described for management of congenital and acquired anorectal stricture/stenosis lesions in cats 2–9. There is only a single previous case report describing balloon dilation of a rectal stricture in a cat and this was an acquired lesion which was treated successfully 8. A retrospective case series of inflammatory rectal strictures in five cats found digital bougienage to be effective at resolving clinical signs, but each case required multiple treatments 9.…”