ENDOSONOGRAPHY OF THE ANAL SPHINCTERS IN SOLITARY RECTAL ULCER SYNDROME

Citation
S. Halligan et al., ENDOSONOGRAPHY OF THE ANAL SPHINCTERS IN SOLITARY RECTAL ULCER SYNDROME, International journal of colorectal disease, 10(2), 1995, pp. 79-82
Citations number
NO
Categorie Soggetti
Gastroenterology & Hepatology
ISSN journal
01791958
Volume
10
Issue
2
Year of publication
1995
Pages
79 - 82
Database
ISI
SICI code
0179-1958(1995)10:2<79:EOTASI>2.0.ZU;2-0
Abstract
Twenty-one patients with histologically proven solitary rectal ulcer s yndrome (SRUS) were examined by anal endosonography (AES) in order to determine the frequency of any ultrasound abnormality. Comparison was made with a group of 17 age and sex matched asymptomatic subjects. Fou r patients with SRUS had anal sphincter defects on AES. All were of th e internal anal sphincter (IAS), which appeared fragmented in two pati ents with complete rectal prolapse. Measurements of internal and exter nal anal sphincter (EAS) diameter and cross-sectional area were taken, excluding the 4 patients with defects. The submucosa was inhomogeneou s (P = 0.0016) and thickness increased in patients with SRUS (median 4 .0 mm vs 2.0 mm; P<0.0001). IAS diameter was increased (median 3.8 mm vs 2.0 mm; P<0.0001), as was cross-sectional area (median 241 sq mm vs 112 sq mm; P < 0.0001). EAS diameter was also increased (median 8.5 m m vs 7.0 mm; P = 0.0173), as was cross-sectional area (median 905 sq m m vs 594 sq mm; P = 0.0052). The ratio of EAS to IAS thickness was red uced in patients with SRUS (median 2.6 vs 4.0; P = 0.0029). The mechan ism of these changes is unclear but apparent muscle hypertrophy on ult rasound may diagnose those patients with SRUS in whom defecatory diffi culty is a predominant symptom.