Abstract
Rectal strictures are uncommon in young patients without a history of malignancy, inflammatory bowel disease or previous surgery. Lymphogranuloma venereum of the rectum has been described as a rare cause of rectal strictures in the western world, mainly in homosexual men and in blacks. It presents with nonspecific symptoms, rectal ulcer, proctitis, anal fissures, abscesses and rectal strictures. Clinical and endoscopic findings as well as histology resemble Crohn's disease, which may be misdiagnosed. Serology is often positive for Chlamydia trachomatis but negative serology is not uncommon. We present two young black women who suffered from chronic diarrhoea, abdominal pain and weight loss. There was no previous history and investigations showed in both cases a long rectal stricture. Serology was positive in one patient. They were treated with erythromycin and azithromycin and they both underwent an anterior resection of the rectum. Postoperative histology confirmed the presence of lymphogranuloma venereum of the rectum. We conclude that rectal lymphogranuloma venereum is a rare cause of rectal strictures but surgeons should be aware of its existence and include it in the differential diagnosis of unexplained strictures in high-risk patients.
Full text
PDF
Images in this article
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Chopda N. M., Desai D. C., Sawant P. D., Nanivadekar S. A., Dave U. R., Satarkar R. P. Rectal lymphogranuloma venereum in association with rectal adenocarcinoma. Indian J Gastroenterol. 1994 Jul;13(3):103–104. [PubMed] [Google Scholar]
- Dan M., Rotmensch H. H., Eylan E., Rubinstein A., Ginsberg R., Liron M. A case of lymphogranuloma venereum of 20 years' duration. Isolation of Chlamydia trachomatis from perianal lesions. Br J Vener Dis. 1980 Oct;56(5):344–346. doi: 10.1136/sti.56.5.344. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Ghatak D. P. A study of urinary fistulae in Sokoto, Nigeria. J Indian Med Assoc. 1992 Nov;90(11):285–287. [PubMed] [Google Scholar]
- Klotz S. A., Drutz D. J., Tam M. R., Reed K. H. Hemorrhagic proctitis due to lymphogranuloma venereum serogroup L2. Diagnosis by fluorescent monoclonal antibody. N Engl J Med. 1983 Jun 30;308(26):1563–1565. doi: 10.1056/NEJM198306303082604. [DOI] [PubMed] [Google Scholar]
- Mostafavi H., O'Donnell K. F., Chong F. K. Supralevator abscess due to chronic rectal lymphogranuloma venereum. Am J Gastroenterol. 1990 May;85(5):602–606. [PubMed] [Google Scholar]
- Rüther U., Rupp W., Müller H. A., Jipp P., Schröter G. Rectal pseudotumor due to Chlamydia trachomatis in a male homosexual. Endoscopy. 1990 Sep;22(5):237–238. doi: 10.1055/s-2007-1012857. [DOI] [PubMed] [Google Scholar]
- de la Monte S. M., Hutchins G. M. Follicular proctocolitis and neuromatous hyperplasia with lymphogranuloma venereum. Hum Pathol. 1985 Oct;16(10):1025–1032. doi: 10.1016/s0046-8177(85)80280-x. [DOI] [PubMed] [Google Scholar]