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Solitary Rectal Ulcer Syndrome With Polyposis
Authors:
Meghana Nadiger, MD
Department of Pediatrics, Flushing Hospital Medical Center, Queens, New York
Maximillian A. Weigelt
Medical Student, American University of the Caribbean, Pembroke Pines, Florida
Susana Rapaport, MD
Department of Pediatrics, Flushing Hospital Medical Center, Queens, New York
Babu S. Bangaru, MD
Chief, Division of Pediatric Gastroenterology, Flushing Hospital Medical Center, Queens, New York; Clinical Associate Professor, Department of Pediatrics, New York University School of Medicine, New York, New York
Citation:
Nadiger M, Weigelt MA, Rapaport S, Bangaru BS. Solitary rectal ulcer syndrome with polyposis [published online November 12, 2018]. Gastroenterology Consultant.
A 14-year-old boy presented with a 2-week history of diarrhea with bright red rectal bleeding. He had had intermittent diarrhea with bleeding for more than 2 years.
History. He denied having abdominal pain, constipation, straining, or pain during defecation. There were no intestinal or extraintestinal manifestations of inflammatory bowel disease (IBD). There was no history suggestive of bleeding problems or clotting problems. He was a known patient with a diagnosis of thalassemia minor. There was no history of drug use or sexual activity. Family history was significant for a sister who had undergone colectomy for ulcerative colitis.
The boy had been seen 2 years ago with a 2-month history of diarrhea with bright rectal bleeding, weight loss of 3.2 kg, and arthralgias, the latter of which had been diagnosed as “growing pains.” There was no other significant medical history. At that time, a complete blood cell count (CBC) showed changes consistent with his thalassemia minor but was otherwise normal. Comprehensive metabolic panel (CMP) results, erythrocyte sedimentation rate, C-reactive protein level, celiac disease antibody panel results, thyroid function test results, stool calprotectin level, stool culture results, Entamoeba histolytica antigen, and Clostridium difficile toxins A and B were all normal or negative. Coagulation studies showed mild von Willebrand disease, which was felt to be not clinically significant. Colonoscopy with terminal ileal intubation and magnetic resonance enterography showed no evidence of IBD. He had been lost to follow-up.
Physical examination. At the current presentation, the boy’s vital signs were stable. Height, weight, and body mass index were normal. There was no scleral icterus or uveitis. There were no aphthous ulcers. The abdomen was soft and nontender with no organomegaly. There were no perianal lesions. The remainder of the physical examination findings were normal. Rectal examination revealed an empty ampulla and yielded no stool for guaiac testing.
Authors:
Meghana Nadiger, MD
Department of Pediatrics, Flushing Hospital Medical Center, Queens, New York
Maximillian A. Weigelt
Medical Student, American University of the Caribbean, Pembroke Pines, Florida
Susana Rapaport, MD
Department of Pediatrics, Flushing Hospital Medical Center, Queens, New York
Babu S. Bangaru, MD
Chief, Division of Pediatric Gastroenterology, Flushing Hospital Medical Center, Queens, New York; Clinical Associate Professor, Department of Pediatrics, New York University School of Medicine, New York, New York
Citation:
Nadiger M, Weigelt MA, Rapaport S, Bangaru BS. Solitary rectal ulcer syndrome with polyposis [published online November 12, 2018]. Gastroenterology Consultant.
A 14-year-old boy presented with a 2-week history of diarrhea with bright red rectal bleeding. He had had intermittent diarrhea with bleeding for more than 2 years.
History. He denied having abdominal pain, constipation, straining, or pain during defecation. There were no intestinal or extraintestinal manifestations of inflammatory bowel disease (IBD). There was no history suggestive of bleeding problems or clotting problems. He was a known patient with a diagnosis of thalassemia minor. There was no history of drug use or sexual activity. Family history was significant for a sister who had undergone colectomy for ulcerative colitis.
The boy had been seen 2 years ago with a 2-month history of diarrhea with bright rectal bleeding, weight loss of 3.2 kg, and arthralgias, the latter of which had been diagnosed as “growing pains.” There was no other significant medical history. At that time, a complete blood cell count (CBC) showed changes consistent with his thalassemia minor but was otherwise normal. Comprehensive metabolic panel (CMP) results, erythrocyte sedimentation rate, C-reactive protein level, celiac disease antibody panel results, thyroid function test results, stool calprotectin level, stool culture results, Entamoeba histolytica antigen, and Clostridium difficile toxins A and B were all normal or negative. Coagulation studies showed mild von Willebrand disease, which was felt to be not clinically significant. Colonoscopy with terminal ileal intubation and magnetic resonance enterography showed no evidence of IBD. He had been lost to follow-up.
Physical examination. At the current presentation, the boy’s vital signs were stable. Height, weight, and body mass index were normal. There was no scleral icterus or uveitis. There were no aphthous ulcers. The abdomen was soft and nontender with no organomegaly. There were no perianal lesions. The remainder of the physical examination findings were normal. Rectal examination revealed an empty ampulla and yielded no stool for guaiac testing.
Authors:
Meghana Nadiger, MD
Department of Pediatrics, Flushing Hospital Medical Center, Queens, New York
Maximillian A. Weigelt
Medical Student, American University of the Caribbean, Pembroke Pines, Florida
Susana Rapaport, MD
Department of Pediatrics, Flushing Hospital Medical Center, Queens, New York
Babu S. Bangaru, MD
Chief, Division of Pediatric Gastroenterology, Flushing Hospital Medical Center, Queens, New York; Clinical Associate Professor, Department of Pediatrics, New York University School of Medicine, New York, New York
Citation:
Nadiger M, Weigelt MA, Rapaport S, Bangaru BS. Solitary rectal ulcer syndrome with polyposis [published online November 12, 2018]. Gastroenterology Consultant.
A 14-year-old boy presented with a 2-week history of diarrhea with bright red rectal bleeding. He had had intermittent diarrhea with bleeding for more than 2 years.
History. He denied having abdominal pain, constipation, straining, or pain during defecation. There were no intestinal or extraintestinal manifestations of inflammatory bowel disease (IBD). There was no history suggestive of bleeding problems or clotting problems. He was a known patient with a diagnosis of thalassemia minor. There was no history of drug use or sexual activity. Family history was significant for a sister who had undergone colectomy for ulcerative colitis.
The boy had been seen 2 years ago with a 2-month history of diarrhea with bright rectal bleeding, weight loss of 3.2 kg, and arthralgias, the latter of which had been diagnosed as “growing pains.” There was no other significant medical history. At that time, a complete blood cell count (CBC) showed changes consistent with his thalassemia minor but was otherwise normal. Comprehensive metabolic panel (CMP) results, erythrocyte sedimentation rate, C-reactive protein level, celiac disease antibody panel results, thyroid function test results, stool calprotectin level, stool culture results, Entamoeba histolytica antigen, and Clostridium difficile toxins A and B were all normal or negative. Coagulation studies showed mild von Willebrand disease, which was felt to be not clinically significant. Colonoscopy with terminal ileal intubation and magnetic resonance enterography showed no evidence of IBD. He had been lost to follow-up.
Physical examination. At the current presentation, the boy’s vital signs were stable. Height, weight, and body mass index were normal. There was no scleral icterus or uveitis. There were no aphthous ulcers. The abdomen was soft and nontender with no organomegaly. There were no perianal lesions. The remainder of the physical examination findings were normal. Rectal examination revealed an empty ampulla and yielded no stool for guaiac testing.
Authors:
Meghana Nadiger, MD
Department of Pediatrics, Flushing Hospital Medical Center, Queens, New York
Maximillian A. Weigelt
Medical Student, American University of the Caribbean, Pembroke Pines, Florida
Susana Rapaport, MD
Department of Pediatrics, Flushing Hospital Medical Center, Queens, New York
Babu S. Bangaru, MD
Chief, Division of Pediatric Gastroenterology, Flushing Hospital Medical Center, Queens, New York; Clinical Associate Professor, Department of Pediatrics, New York University School of Medicine, New York, New York
Citation:
Nadiger M, Weigelt MA, Rapaport S, Bangaru BS. Solitary rectal ulcer syndrome with polyposis [published online November 12, 2018]. Gastroenterology Consultant.
A 14-year-old boy presented with a 2-week history of diarrhea with bright red rectal bleeding. He had had intermittent diarrhea with bleeding for more than 2 years.
History. He denied having abdominal pain, constipation, straining, or pain during defecation. There were no intestinal or extraintestinal manifestations of inflammatory bowel disease (IBD). There was no history suggestive of bleeding problems or clotting problems. He was a known patient with a diagnosis of thalassemia minor. There was no history of drug use or sexual activity. Family history was significant for a sister who had undergone colectomy for ulcerative colitis.
The boy had been seen 2 years ago with a 2-month history of diarrhea with bright rectal bleeding, weight loss of 3.2 kg, and arthralgias, the latter of which had been diagnosed as “growing pains.” There was no other significant medical history. At that time, a complete blood cell count (CBC) showed changes consistent with his thalassemia minor but was otherwise normal. Comprehensive metabolic panel (CMP) results, erythrocyte sedimentation rate, C-reactive protein level, celiac disease antibody panel results, thyroid function test results, stool calprotectin level, stool culture results, Entamoeba histolytica antigen, and Clostridium difficile toxins A and B were all normal or negative. Coagulation studies showed mild von Willebrand disease, which was felt to be not clinically significant. Colonoscopy with terminal ileal intubation and magnetic resonance enterography showed no evidence of IBD. He had been lost to follow-up.
Physical examination. At the current presentation, the boy’s vital signs were stable. Height, weight, and body mass index were normal. There was no scleral icterus or uveitis. There were no aphthous ulcers. The abdomen was soft and nontender with no organomegaly. There were no perianal lesions. The remainder of the physical examination findings were normal. Rectal examination revealed an empty ampulla and yielded no stool for guaiac testing.
