Volume : VIII, Issue : XII, December - 2019

A RARE CASE OF MUCOSAL PROLAPSE SYNDROME INVOLVING THE ASCENDING COLON

Dr Jayesh V. Parikh, Dr Parth R. Dalal, Dr Anilkumar C. Pargi, Dr. Sachin Vishwakarma

Abstract :

Mucosal prolapse syndrome (also known as, Solitary rectal ulcer syndrome, Colitis cystica profunda)(5) most commonly involves the rectum wherein the mucosa and sub mucosa prolapse outside the external anal verge for approximate length of 1–4 cm.(7) Patients present with chronic constipation, straining and rectal bleeding.(7) Patients with SRUS (Solitary rectal ulcer syndrome) are usually young females around the age of 25 years with history of chronic constipation.(7) In this case report, A 23–year male patient presented a chronic history of abdominal distension, localised to right lower quadrant, intermittent, ill defined, painless, non–progressive in size and not related to feeding, history of Malena, anorexia, weight loss and constipation, suggestive of early onset colonic malignancy. CECT shows diffuse circumferential heterogeneous enhancing irregular wall thickening seen involving mid ascending colon with marked luminal narrowing and resultant proximal dilation. Lesion involving colon for a length of 70 mm with maximum wall thickening of 15mm, suggestive of malignancy. Coloscopy shows Polypoidal growth involving entire circumference of ascending colon, Biopsy suggestive of Adenomatous polyp. Intraoperative 8 cm length of ascending colon, about 4 cm from ileocecal junction, was thickened and firm in consistency, Terminal ileum and proximal ascending colon were dilated and filled with stool. A right hemicolectomy with end to end ilio–transverse anastomosis was done, Specimen histology suggests that of mucosal prolapse syndrome with foci suggestive of colitis cystica. Mucosal prolapse syndrome, though a rare entity, should be kept in mind when dealing with per rectal bleed in a young patient. It’s resemblance to Crohn’s disease and early onset colonic carcinoma in a young patient poses a diagnostic difficulty. Very few instances of mucosal prolapse of ascending colon have been documented. Trans anal and abdominal procedures are practised for SRUS and internal intussusception, but their application in rare presentation like this one needs further study.

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Article: Download PDF    DOI : 10.36106/ijsr  

Cite This Article:

A RARE CASE OF MUCOSAL PROLAPSE SYNDROME INVOLVING THE ASCENDING COLON, Dr Jayesh V. Parikh, Dr Parth R. Dalal, Dr Anilkumar C. Pargi, Dr. Sachin Vishwakarma INTERNATIONAL JOURNAL OF SCIENTIFIC RESEARCH : Volume-8 | Issue-12 | December-2019

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