|
Solitary rectal ulcer syndrome (SRUS) is a chronic disease of the rectum. Although SRUS is a benign condition there are
studies which suggest that chronic ischaemia which occurs in the SRUS may lead to "transitional mucosa" that is similar
to that adjacent to colorectal carcinomas and adenomas and may lead to colorectal dysplasia and carcinoma development.
The exclusion of primary or metastatic malignancy is the most important aim in the differential diagnosis of SRUS. In our
study we assess the possibilities of autofluorescence colonoscopy (AFC) in diagnosis and management of SRUS.
We performed white light colonoscopy first. The tissue samples were taken for pathological examination. When SRUS
was histopathologically confirmed AFC was performed by means of Xillix OncoLIFE. During AFC numerical colour
value (NCV) of autofluorescence of SRUS lesions was noted.
During 1946 colonoscopies eight persons were diagnosed as having solitary rectal ulcer syndrome. We did not observe
autofluorescence increase in case of polipoid and flat ulcer lesions (NCV 0,39-0,67; mean 0,525) and little increase of
autofluorescence in case of erythema lesion (NCV- 0,94).
SRUS is a rare disorder of the rectum but it causes differential diagnosis problems. The most common reason for
incorrect diagnosis are inadequate tissue specimens. AFC allows to reveal subtle areas within the lesions of more intense
autofluorescence and localizes the potential cancer-transformating dysplasia. In this way the most representative area
with highest risk of pre- or cancerous changes, for biopsy specimen is indicated.
|
