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Endoscopy ligation by the „loop and let go“ technique as a treatment of rectal syndrome caused by a rectal lipoma


Authors: Baťková B. 1;  Maceček J. 1;  Staňka B. 1;  Stašek M. 2;  Černoch J. 1
Authors‘ workplace: Gastroenterologické oddělení, Nemocnice Prostějov, Středomoravská nemocniční, a.  s. 1;  I. chirurgická klinika LF UP a FN Olomouc 2
Published in: Gastroent Hepatol 2018; 72(6): 534-537
Category:
doi: https://doi.org/10.14735/amgh2018534

Overview

Rectal syndrome is a condition characterized by frequent compulsive or painful defecation and is often as­sociated with a small amount of blood in stool or mucus. Symp­toms usual­ly appear slowly, depend­­ing on the cause of the problem. It often takes weeks to months for the patient to seek medical attention. Dif­ferential dia­gnosis of rectal syndrome encompas­ses both functional disorders and morphological­ly defined conditions includ­­ing a wide range of anorectal dysfunctions. Dia­gnosis is often a multidisciplinary and an impotent role is played by endoscopic methods. This case report describes a case of rectal syndrome caused by a lipoma in the anorectal area, which was dia­gnosed by colonoscopy and treated by the „loop and let go“ ligation technique. A scar after ligation of the lipoma was observed at 6 weeks and the patient‘s symp­toms completely disappeared. Rectal lipoma is less com­mon in structural pathology, which may be the cause of rectal syndrome, even if the lesion is relatively smal­l. Endoscopic ther­apy is a safe, less burdensome first therapeutical choice, and has the advantage of outpatient treatment with minimal adverse events. The alternative to endoscopic treatment of unsolvable lesions is surgery.

Key words:

anorectal dysfunction – rectal syndrome – lipoma

Submitted: 11. 9. 2018

Accepted: 10. 10. 2018


Sources

1. Horák L, Skřička T, Šlauf P et al. Praktická proktologie. Praha: Grada Publish­­ing 2013.

2. Prokešová J, Dolina J. Anorektální dysfunkce. Interní medicína pro praxi 2009; 11(5): 218–220.

3. Gerjy R, Lindhof­f-Larson A, Nyström PO. Grade od prolapse and symp­toms of haemor­rhoids are poorly cor­related: results of a clas­sification algorithm in 270 patients. Colorectal Dis­ease 2008; 10(7): 694–700. doi: 10.1111/j.1463-1318.2008.01498.x.

4. Mansoor S, Dolkar T, El-Fanek H. Polyps and polypoid lesions of the colon. Int J Surg Pathol 2013; 21(3): 215–223. doi: 10.1177/1066 896913481060.

5. Zavoral M, Vojtěchová G, Suchánek Š. Klasifikace kolorektálního karcinomu. Onkologie 2013; 7(4): 172–175.

6. Hayashi N, Tanaka S, Hewett DG et al. Endoscopic prediction of deep submucosal invasive carcinoma: validation of the nar­row-band imag­­ing international colorectal endoscopic (NICE) clas­sification. Gastrointest Endosc 2013; 78(4): 625–632. doi: 10.1016/j.gie.2013.04.185.

7. Falt P, Urban O, Vítek P et al. Koloskopie. Praha: Grada Publish­­ing 2015.

8. Urban O, Falt P, Fojtík P et al. Comparison of endoscopic mucosal resection and endoscopic submucosal dis­section in the treatment of flat neoplastic lesions in the rectum. Gastroent Hepatol 2018; 72(3): 193–198. doi: 10.14735/amgh2018193.

9. Marshall GB, Dunham C, Wiemer C et al. Ans­wer to case of the month 132. Adult ileocolic intus­susception secondary to a submucosal lipoma. Can As­soc Radiol J 2008; 59(2): 89–91.

10. Gabalec L, Adámková S, Nedvěd K et al. Intususcepce způsobená lipomem tlustého střeva. Folia Gastroenterol Hepatol 2009; 7(2), 74–76.

11. Pfeil SA, Weaver MG, Abdul-Karim FW et al. Colonic lipomas: outcome of endoscopic removal. Gastrointest Endosc 1990; 36(5): 435–438. doi: 10.1159/000260053.

12. Hwang JH, Saunders MD, Rulyak SJ et al. A prospective study compar­­ing endoscopy and EUS in the evaluation of GI subepithelial mas­ses. Gastrointest Endosc 2005; 62(2): 202–208.

13. Ivekovic H, Rustemovic N, Brkic T et al. Endoscopic ligation (“Loop-And-Let-Go”) is ef­fective treatment for large colonic lipomas: a prospective validation study. BMC Gastroenterol 2014; 14: 122. doi: 10.1186/1471-230X-14-122.

14. Kopáčová M, Rejchrt S, Bureš J. Unroof­­ing technique as an option for the endoscopic treatment of giant gastrointestinal lipomas. Acta Med 2015; 58(4): 115–118. doi: 10.14712/18059694.2016.1.

Labels
Paediatric gastroenterology Gastroenterology and hepatology Surgery

Article was published in

Gastroenterology and Hepatology

Issue 6

2018 Issue 6

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