Rectal mucocele in the anterior wall of the rectum

Abstract

An 84-year-old man presented in 2009 with a sensation of discomfort in his anus, combined with difficulty in urination. He had previously undergone a haemorrhoidectomy in 1964. After examination, he was diagnosed with a rectal mucosal cyst and followed up for observation. In 2015, he presented to our hospital complaining that the cyst was prolapsing from his anus. CT revealed a 48×41 mm cystic mass in the anterior wall of the rectum. Tumour extirpation, via a transanal route, was performed. The postoperative pathological diagnosis confirmed a rectal mucocele. Rectal mucoceles are extremely rare, with no prior report of a mucocele in the anterior wall of the rectum. In this case, we believe the mucocele developed from an invagination of the mucous membrane or obstruction of the anal gland during suturing during the previous haemorrhoid surgery.

Blind loop mucocele of a side-to-end colorectal anastomosis as a rare cause of large bowel obstruction

“…Rectal mucoceles are exceedingly rare. Rectal pouch mucoceles following Hartmann’s procedure (proctosigmoidectomy) and rectal wall mucoceles have been known to cause obstruction or compression of other pelvic structures 1 2. To our knowledge and after thorough review of the literature, LBO due to blind colonic limb mucocele of a side-to-end colorectal anastomosis has not been described.…”

“…Radiographic images were essential to narrow down the diagnostic differentials. CT imaging (figure 1) suggested that this could be a rectal wall mucocele—a rare but previously described diagnosis2; however, further imaging was imperative. High-resolution MRI (figure 2) suggested a mucocele of the residual blind colonic loop of a side-to-end anastomosis.…”

“…Similar cases of mucocele-causing LBO have not yet been described in the literature, with previously reported cases predominantly involving the appendix. Rectal stump mucoceles have been described following Hartmann’s procedure as well as rectal mucocele formation in the anterior wall of the rectum 1 2. Increasing clinicians’ awareness, and adding to the publicly accessible literature regarding blind colonic loop mucocele of a side-to-end anastomosis as a rare cause of LBO, are important for clinicians’ continual learning and for up-to-date accurate preoperative consenting of patients.…”

Malignant obstruction of the rectal stump as an etiological agent of mucocele

“…Entre los factores que pueden contribuir al acúmulo de moco en la luz del muñón rectal después de una cirugía se han descrito: obstrucción luminal, estenosis, aumento del tono anal, así como inflamación, cicatrización y epitelización de la pared intestinal. Dichas condiciones evitan la adecuada eliminación del moco, lo que genera un asa con ambos extremos ocluidos, fomenta la formación de un mucocele, que va a seguir aumentando de tamaño hasta volverse sintomático (2,5).…”

“…El mucocele, desde el punto de vista histológico, consiste en una cavidad con contenido mucinoso rodeada por epitelio o tejido de granulación (1). Se ha descrito en varias localizaciones, pero las más frecuentes son los senos paranasales, el apéndice cecal y la vesícula biliar (2). En una búsqueda realizada en PubMed, en los últimos 20 años se encuentran diez reportes de casos y dos series de casos que describen mucoceles rectales, una con ocho casos y otra con siete casos (3)(4)(5)(6).…”