One patient had severe proctitis with
rectal stenosis and was suspected of having had inflammatory bowel disease (IBD) for 1 year at the time of the first interview.
The patient was placed in a supine position, and a total of 100 U botulinum toxin A (BoTox A) was injected into the muscularis propria at 3, 6, and 9 o'clock from the
rectal stenosis. The number of bowel movements increased 2 weeks after the injection, the symptoms of bloating were relieved, and the abdominal circumference was reduced to 88 cm.
The incidence of
rectal stenosis varied among different studies, many studies describing no occurrence of rectal stricture while few studies reporting such complication in 2% (1/49) [23]--13.3% (2/15) [7].
Follow up was done after 3rd, 7th, 15th and 30th day of surgery and 6 months and 1 year to know patient satisfaction and any late complications like
rectal stenosis and recurrence.
Our case of secondary RLP was consistent with previous reports in that significant circumferential
rectal stenosis was encountered with LGI endoscopy.[sup.7,8] In addition, our endoscopic biopsies were inconclusive for malignancy, which is a common finding in RLP,[sup.7,8] as the disease primarily involves the submucosa and muscularis propria while sparing the mucosa.
It has been reported as an unusual complication after diversion transverse loop colostomy in a patient with long-standing ulcerative colitis resulting from distal stomal and
rectal stenosis and accumulation of mucus in the closed loop over many years (5).
In the SH group, five complications occurred: two cases of fecal urgency; one
rectal stenosis that required surgery; and two postoperative bleeds that required readmission, but were successfully addressed in one visit.