Mucocele, considered as a variant of rectal pocket, is fairly rare among the complications and it may determine problems of differential diagnosis and management with pararectal lesions, especially abscess. Therefore, the surgeon should be aware about their early identification and adequate treatment. The broad spectrum of complications after stapled procedure has an overall rate that ranges from 12,7% to 36,4%. It is associated with low postoperative pain, short hospital stay, fast return to work and high patients satisfaction. Introduction Stapled hemorrhoidopexy is a safe and effective treatment for circumferential hemorrhoidal prolapse.
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This is an open access article under the CC BY-NC-ND license ().ġ. Published by Elsevier Ltd on behalf of IJS Publishing Group Ltd. The knowledge of the possible rare complications is at the base of a correct treatment. In case of perineal discomfort after stapled procedure the physical examination combined with 3D 360◦ transanal ultrasound is necessary to reach the diagnosis. CONCLUSION: Mucocele is a rare complication of stapled hemorrhoidopexy that may remain asymptomatic for a long period. Surgery is the treatment of choice with a transanal approach that is generally preferred to the trans-perineal. The differential diagnosis between mucocele and pararectal lesions, especially abscess may be often difficult. DISCUSSION: Mucocele is a rare complication which usually occurs after months from the operation and it is considered a variant of rectal pocket and it is usually completely separated from the rectal lumen at the level of stapled line.
After one year the patient is completely asymptomatic with normal defecation. A surgical operation was performed and a great amount of mucus was drained. 3D 360◦ transanal ultrasound showed a pararectal fluid collection. The anal exploration showed a bulge of the right lateral wall of the rectum at the level of stapled line without any related pain. Two years after surgery she reported to our center the occurrence of perineal discomfort, anal spasm and tenesmus. PRESENTATION OF CASE: Female patient, 57 years was treated with stapled hemorrhoidopexy. The overall rate of complications ranges from 12,7% to 36,4% and the surgeon should be aware about their early identification and adequate treatment. General, Emergency and Mini-invasive Surgery, Careggi University Hospital, Florence, Italy Proctological and Perineal Surgical Unit, Cisanello University Hospital, Pisa, ItalyĪrticle history: Received 13 November 2016 Received in revised form 13 February 2017 Accepted 13 February 2017 Available online 20 February 2017 Keywords: Mucocele Rectal pocket Stapled hemorroidopexy Complication Henorrhoids Case reportĪ b s t r a c t INTRODUCTION: Stapled hemorrhoidopexy is a safe and effective treatment for circumferential hemorrhoidal prolapse. International Journal of Surgery Case Reports journal homepage: Mucocele complicating stapled hemorrhoidopexy Asia Grapsi a, Alessandro Sturiale b,∗, Bernardina Fabiani b, Gabriele Naldini b a b CASE REPORT – OPEN ACCESS International Journal of Surgery Case Reports 33 (2017) 38–40Ĭontents lists available at ScienceDirect
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