Liu SH, Kang JC, Hu JM, Chen CY, Lin KH, Pu TW. Treatment of benign rectal stricture caused by repeated anal insertion by endoscopy and balloon dilation: A case report. World J Gastrointest Endosc 2024; 16(2): 91-97 [PMID: 38464821 DOI: 10.4253/wjge.v16.i2.91]
Corresponding Author of This Article
Ta-Wei Pu, MD, Lecturer, Division of Colon and Rectal Surgery, Department of Surgery, Songshan Branch, Tri-Service General Hospital, National Defense Medical Center, No. 131 Jiankang Road, Taipei 105, Taiwan. tawei0131@gmail.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Shih-Hung Liu, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei 114, Taiwan
Jung-Cheng Kang, Division of Colon and Rectal Surgery, Department of Surgery, Taiwan Adventist Hospital, Taipei 105, Taiwan
Je-Ming Hu, Chao-Yang Chen, Division of Colon and Rectal Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei 114, Taiwan
Kuan-Hsun Lin, Division of Thoracic Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei 114, Taiwan
Ta-Wei Pu, Division of Colon and Rectal Surgery, Department of Surgery, Songshan Branch, Tri-Service General Hospital, National Defense Medical Center, Taipei 105, Taiwan
Author contributions: Liu SH and Kang JC drafted the manuscript; TW Pu revised the final draft of the manuscript; Lin KS contributed to data acquisition; Chen CY and Hu JM contributed to the investigation and interpretation of the data; All authors have read and approved this version of the manuscript.
Informed consent statement: Written informed consent was obtained from the patient to publish this report and accompanying images.
Conflict-of-interest statement: All the authors declare that they have no conflict of interest to disclose.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Ta-Wei Pu, MD, Lecturer, Division of Colon and Rectal Surgery, Department of Surgery, Songshan Branch, Tri-Service General Hospital, National Defense Medical Center, No. 131 Jiankang Road, Taipei 105, Taiwan. tawei0131@gmail.com
Received: October 12, 2023 Peer-review started: October 12, 2023 First decision: December 8, 2023 Revised: December 28, 2023 Accepted: January 22, 2024 Article in press: January 22, 2024 Published online: February 16, 2024 Processing time: 111 Days and 2.8 Hours
Abstract
BACKGROUND
Benign rectal strictures can be categorized as primary (disease-related) and secondary (surgical anastomosis-related). Secondary strictures arise from surgical complications, whereas primary strictures have diverse etiologies, including various inflammatory conditions. Benign strictures are usually managed by surgery and endoscopy. We present an unusual etiology of benign rectal stricture caused by the repeated insertion of foreign objects into the rectum for sexual purposes, resulting in rectal injury and subsequent chronic inflammation.
CASE SUMMARY
A 53-year-old man presented to the outpatient clinic of the Colorectal Surgery Department with symptoms of chronic constipation and bloody stools. The patient previously experienced rectal injury due to foreign object insertion for sexual purposes. Colonoscopy revealed benign circumferential narrowing of the rectum. He underwent treatment by endoscopic argon plasma coagulation and balloon dilation and follow-up as an outpatient for 4 months. A colonoscopy at the end of the follow-up period revealed no evidence of rectal stricture relapse.
CONCLUSION
A history of rectal injury, followed by chronic inflammation, should be considered in patients with benign rectal strictures. Management with endoscopic argon plasma coagulation and balloon dilation can prevent the need for surgical resection of benign rectal strictures.
Core Tip: The etiologies of benign rectal stricture are primarily associated with chronic inflammation and post-surgical complications. We describe an unusual etiology caused by repeated insertion of foreign objects into the rectum for sexual purposes, resulting in rectal injury and subsequent chronic inflammation. Initiating treatment with endoscopic management and then considering surgical resection, if unsuccessful, might be the most suitable therapeutic strategy. Endoscopic argon plasma coagulation combined with balloon dilation is beneficial for treating benign rectal stricture.
