MUCOSAL PROLAPSE SYNDROME - DIAGNOSIS WITH ENDOSCOPIC US

PURPOSE: To determine the value of endoscopic ultrasound (US) in the d iagnosis of mucosal prolapse syndrome (MPS), also known as solitary ul cer of the rectum. MATERIALS AND METHODS: Three male and two female pa tients (age range, 17-66 years) with biopsy-proved MPS underwent endos copic US. The average rectal wall thicknesses of the affected areas we re compared with those of normal-appearing mucosa. RESULTS: The gross appearance of the rectal lesions was classified into three types: poly poid (n = 2), flat (n = 1), and ulcerative (n = 2). In all three types of lesions, endoscopic US demonstrated smooth, diffuse thickening of the third layer of the rectal wall; the other layers had minimal thick ening. Neither a solid hypoechoic mass nor a transmural infiltrating l esion was visible, and the five-layer structure of the rectal wall was completely preserved. In the polypoid lesions, the third layer was wi nding as well as thickened, and microcystic components were occasional ly found. CONCLUSION: Endoscopic US enabled differentiation of MPS fro m other conditions such as malignant neoplasia and Crohn disease.