Rectal injury induced by anorectal manometry in two patients without a history of surgery / 대한내과학회지

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.