Solitary rectal ulcer syndrome—The role of autofluorescence colonoscopy

Summary 

Background

Solitary rectal ulcer syndrome (SRUS) is a rare disorder of the rectum but it causes differential diagnosis problems.

Aim

To determine the potential use of autofluorescence colonoscopy (AFC) in diagnosis of SRUS.

Material and methods

We performed 1618 colonoscopies. After the medical history was taken white light colonoscopy was performed. The tissue samples were taken for routine pathological examination. When SRUS was histopathologically confirmed AFC was performed by means of OncoLIFE. The mean time lapse between the two colonoscopies was 4 weeks. During AFC numerical colour value (NCV) of autofluorescence of SRUS lesions was noted.

Results

During 1618 colonoscopies six persons were diagnosed as having solitary rectal ulcer syndrome (0.37%). The mean age was 43.8 years. There were two men and four women. In our material the endoscopic spectrum was: three (50%) polypoid lesions, two (33.33%) flat ulcers and one case (16.66%) of isolated, local erythema with hyperemia. We did not observe decrease of fluorescence in case of polipoid and flat ulcer lesions (NCV 0.39–0.67; mean 0.525) and little decrease of fluorescence in case of erythema lesion (NCV −0.94).

Conclusion

Autofluorescence colonoscopy by means of OncoLIFE appears to be a promising approach in diagnosis of SRUS. The estimation of numerical colour value which is an objective test of autofluorescence intensity, facilitates the differential diagnosis and helps to chose the right management of SRUS.

Keywords: Solitary rectal ulcer syndrome, Autofluorescence colonoscopy