Radiology, Vol 191, 527-530, Copyright © 1994 by Radiological Society of North America
Mucosal prolapse syndrome: diagnosis with endoscopic US
K Hizawa, M Iida, H Suekane, R Mibu, Y Mochizuki, T Yao and M Fujishima
Second Department of Internal Medicine, Faculty of Medicine, Kyushu University, Fukuoka, Japan.
PURPOSE: To determine the value of endoscopic ultrasound (US) in the
diagnosis of mucosal prolapse syndrome (MPS), also known as solitary ulcer
of the rectum. MATERIALS AND METHODS: Three male and two female patients
(age range, 17-66 years) with biopsy-proved MPS underwent endoscopic US.
The average rectal wall thicknesses of the affected areas were compared
with those of normal-appearing mucosa. RESULTS: The gross appearance of the
rectal lesions was classified into three types: polypoid (n = 2), flat (n =
1), and ulcerative (n = 2). In all three types of lesions, endoscopic US
demonstrated smooth, diffuse thickening of the third layer of the rectal
wall; the other layers had minimal thickening. Neither a solid hypoechoic
mass nor a transmural infiltrating lesion was visible, and the five-layer
structure of the rectal wall was completely preserved. In the polypoid
lesions, the third layer was winding as well as thickened, and microcystic
components were occasionally found. CONCLUSION: Endoscopic US enabled
differentiation of MPS from other conditions such as malignant neoplasia
and Crohn disease.
