Stomach and Intestine(Tokyo) Volume 54, Issue 2 (February 2019)

The Multiple Elevated Type Rectal Mucosal Prolapse Syndrome in which Endoscopic Submucosal Dissection was Effective for Improvement of Anemia, Report of a Case Shusuke Nakauchi 1 , Kiyotaka Okawa 1 , Wataru Ueda 1 , Hiroshi Ono 1 , Masato Miyano 1 , Etsushi Kawamura 1 , Koji Sano 1 , Hiroko Ohba 2 , Seiko Yamaguchi 1 , Tetsuya Aoki 1 , Osamu Kurai 1 , Masahiro Onodera 3 1Department of Gastroenterology, Osaka City Juso Hospital, Osaka, Japan 2Department of Internal Medicine, Osaka City Kousaiin Hospital, Osaka, Japan 3Department of Pathology, Kawanishi City Hospital, Kawanishi, Japan Keyword: 直腸粘膜脱症候群 , MPS , 隆起型 , 多発 , 内視鏡的粘膜下層剝離術 , ESD , 貧血 pp.278-284
Published Date 2019/2/25
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 A 20's-year-old man presented to a local doctor with complaints of bleeding during defecation. The patient underwent colonoscopy for advanced anemia. Multiple protruding lesions were found in the rectum. The doctor did not make a diagnosis based on lesion biopsy and referred the patient to our hospital for detailed examination. Colonoscopy revealed large, red, elevated lesions with white mucus on the second Houston's valve, first Houston's valve, and bottom of the rectum. We performed endoscopic mucosal resection of the small elevated lesion for diagnosis. Based on the histological findings, we diagnosed the patient with rectal mucosal prolapse syndrome. Because there was no improvement in anemia, we performed ESD(endoscopic submucosal dissection)for the three large elevated lesions. There was a recurrence in two lesions on the second Houston's valve and first Houston's valve 2 years after ESD. There was a shallow ulcer with redness on the second Houston's valve due to defecation guidance and laxative administration 5 years after ESD. The patient's anemia improved. We demonstrated the efficacy of ESD for large lesions of mucosal prolapse syndrome.

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54巻2号 (2019年2月)
電子版ISSN 1882-1219 印刷版ISSN 0536-2180 医学書院