Ann Coloproctol.  2014 Feb;30(1):50-53. 10.3393/ac.2014.30.1.50.

Iatrogenic Rectal Diverticulum With Pelvic-Floor Dysfunction in Patients After a Procedure for a Prolapsed Hemorrhoid

• Na SK
• Jung HK
• Shim KN
• Jung SA
• Chung SS

• KMID: 2134013
• DOI: http://doi.org/10.3393/ac.2014.30.1.50

Abstract

Diverticula are frequently seen in the sigmoid, descending, ascending and transverse colons whereas rectal diverticula are extremely rare. The stapled rectal mucosectomy for the treatment of a prolapsed hemorrhoid is less painful and has lower morbidity; therefore, it has been commonly used despite possible complications. This paper reports a case of a rectal diverticulum that developed after a procedure for prolapsed hemorrhoids (PPH). A 42-year-old man with a history of hemorrhoidectomies came to the hospital because of constipation. On sigmoidoscopy, a 2-cm-sized, feces-filled pocket was located just above the anorectal junction. After removal of the fecal material, a huge rectal diverticulum (-4 cm in diameter) was seen. Pelvic magnetic resonance imaging (MRI) confirmed the diagnosis of rectal diverticulum outpouching through the muscular layer of the intestine in a left posterolateral direction. The patient was discharged without complication after a transanal diverticulectomy had been performed, and the direct rectal wall had been repaired.

Keyword

Diverticulum; Prolapsed hemorrhoids; Hemorrhoidectomy

MeSH Terms

Adult
Colon, Sigmoid
Colon, Transverse
Constipation
Diagnosis
Diverticulum*
Hemorrhoidectomy
Hemorrhoids*
Humans
Intestines
Magnetic Resonance Imaging
Sigmoidoscopy