SOLITARY RECTAL ULCER SYNDROME: CLINICOPATHOLOGICAL FEATURES OF 131 PATIENTS PRESENTING TO HOSPITALS OF YAZD FROM 2011 TO 2015

Introduction: Solitary rectal ulcer is an uncommon rectal disorder that causes variable clinical symptoms from rectal and perianal pain to rectorrhagia and prolapse of the rectum. In most patients, the ulcer is solitary, but in fewer patients, multiple ulcer formations are visible in colonoscopy examination. We decided to study solitary rectal ulcer patients over a period of five years to become aware of the situation of the disease in our centers.

Materials and Methods: The hospital folders of all patients with solitary rectal ulcer that were admitted to colonoscopy and pathology wards of Shahid Sadoughi and Mortaz general hospitals, retrospectively, were studied by census method from 2011 to 2015. All pathology slides were re-reviewed by two specialist pathologists. Data were gathered using a prepared checklist composed of variables such as age, gender, date of admission, number of ulcers found in colonoscopy, histopathology findings, and patient’s clinical signs and symptoms. The data were analyzed in SPSS version 17 using descriptive statistics and reported as percentages and frequencies.

Results: In this study, records of 131 patients were studied: 72 (55%) were male and 59 (45%) were female (age range: 9–83), with a mean age of 36.77. The most common clinical symptom was rectorrhagia, 59 (45%), followed by constipation, 53 (40.5%), and the least common clinical symptom was rectorrhagia and diarrhea, 1 (0.8%). The most frequent age group was the 21–40 (55%) year old group. According to colonoscopy, 129 (98.5%) patients had a solitary ulcer and only two (1.5%) patients had multiple ulcers. Surface serration with superficial ulcerations and widening and obliteration of lamina propria by fibromuscular connective tissue were the commonest pathological findings in all of the samples. The least findings pathologically were polypoid surface and crypt hyperplasia, 23 (17.5%).

Conclusions: Overall, in present study solitary rectal ulcer affects younger adults more, and is more common in men than in women.