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Inicio Cirugía Española (English Edition) Proctalgia and obstructive defecation syndrome secondary to internal anal sphinc...
Información de la revista
Vol. 101. Núm. 9.
Páginas 643 (septiembre 2023)
Visitas
62
Vol. 101. Núm. 9.
Páginas 643 (septiembre 2023)
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Proctalgia and obstructive defecation syndrome secondary to internal anal sphincter idiopathic hypertrophy
Hipertrofia idiopática del esfínter anal interno como causa de proctalgia y síndrome de defecación obstructiva
Visitas
62
Natalia Suárez Pazosa,b,
Autor para correspondencia
natalia.suarez@scsalud.es

Corresponding author.
, Lidia Cristóbal Pocha,b, Francisco José González Sánchezc, Julio del Castillo Diegoa,b
a Unidad Coloproctología, Cirugía General y del Aparato Digestivo, Hospital Universitario Marqués de Valdecilla, Santander, Spain
b Instituto de Investigación Sanitaria Valdecilla (IDIVAL), Santander, Spain
c Radiodiagnóstico, Hospital Universitario Marqués de Valdecilla, Santander, Spain
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Summary

We present the case of a 53-year-old woman, whose medical history of interest only included cesarean section for the delivery of twins. She reported symptoms of proctalgia and difficulty passing stool over the past 3 years. On physical examination, she presented with pain during digital rectal examination and anal hypertonia, with no associated fissure. We performed endoanal ultrasound and requested a dynamic pelvic MRI, which showed homogeneous circumferential thickening of the IAS, in addition to tricompartmental pelvic floor descent during defecation, with no relaxation of the IAS. The patient did not improve with oral muscle relaxants, topical nifedipine, or local infiltration of botulinum toxin, and she is awaiting internal lateral sphincterotomy (Figs. 1 and 2).

Fig. 1.

Axial view of the endoanal ultrasound.

(0.22MB).
Fig. 2.

Axial view in T2 sequence with fat saturation.

(0.23MB).
Funding

The study was not funded by any organization.

Conflict of interests

None of the authors present conflicts of interest.

Instituto de Investigación Sanitaria Valdecilla (IDIVAL) ID https://orcid.org/0000-0002-0848-4682.

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