The Korean Journal of Internal Medicine

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Original Article
Korean J Med. 2010;78(6):732-736.
수술의 과거력이 없는 환자에서 항문직장 내압검사 후 발생한 직장 손상
정상수, 명승재, 김이랑, 정훈용, 양석균, 김진호
Department of Internal Medicine, Inha University College of Medicine, Incheon, Korea
Rectal injury induced by anorectal manometry in two patients without a history of surgery
Sang-Su Jung, Seung-Jae Myung, Yi Rang Kim, Hwoon-Yong Jung, Suk-Kyun Yang, Jin-Ho Kim
인하대학교 의과대학 내과학교실


Abstract
Colorectal injury related to anorectal manometry is very rare and is mostly associated with previous rectal surgery. We experienced two cases of colorectal injury related to anorectal manometry in patients without a history of surgery. The anorectal manometry finding of the first patient suggested rectal hyposensitivity, and the maximum tolerable volume was measured as 350 mL. After anorectal manometry, she complained of hematochezia. Sigmoidoscopy showed a deep 5 cm ulcer with vessel exposure at the rectum. She recovered after conservative treatment. In the second case, rectal bleeding occurred while measuring the maximal tolerable rectal volume. A 2.5 cm mural defect and 4 cm mucosal defect were detected in the rectosigmoid area at sigmoidoscopy. Computed tomography showed intraperitoneal free air around the distal sigmoid colon. She improved after conservative management. We suggest that anorectal manometry be performed with great caution, even in patients without a history of surgery. (Korean J Med 78:732-736, 2010)

Keywords :Anorectal manometry, Complications, Intestinal perforation
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