Volume 80, Issue 1 (April 2022)                   Tehran Univ Med J 2022, 80(1): 70-75 | Back to browse issues page

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Seyed Sharifi S H, Tavassoli A, Etezadpour M. A case report peritonitis and Retropneumoperitoneum after procedure for prolapsed hemorrhoid: a case report. Tehran Univ Med J 2022; 80 (1) :70-75
URL: http://tumj.tums.ac.ir/article-1-11633-en.html
1- Department of General Surgery, School of Medicine, North Khorasan University of Medical Sciences, Bojnurd, Iran.
2- Endoscopic and Minimally Invasive Surgery Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
3- Endoscopic and Minimally Invasive Surgery Research Center, Mashhad University of Medical Sciences, Mashhad, Iran. , Etezadpourm@mums.ac.ir
Abstract:   (958 Views)
Background: Hemorrhoids are one of the most common perianal diseases. They have several surgical and non-surgical treatment methods. Among surgical procedures, Stapler hemorrhoidopexy method has recently gained widespread acceptance. Hemorrhoidopexy with a circular stapler usually has a series of common and mild complications and a few rare and life-threatening complications such as rectal perforation, which requires emergency surgery. In this article, a case of rectal perforation in a middle-aged man following hemorrhoidopexy with Circular Stapler in a Procedure for Prolapse and Hemorrhoids (PPH) is reported that he underwent emergency surgery.
Case Presentation: The patient is a 43-year-old man who presented to the emergency department of Mashhad Ghaem Hospital in June 2020 due to acute general abdominal pain especially in the lower abdomen that started 3 days ago the patient has a history of hemorrhoidopexy with a Circular Stapler in a Procedure for Prolapse and Hemorrhoids (PPH) 5 days ago. The patient had a fever at the time of referral, other vital signs were normal. During the examination, the patient had tenderness and rebound tenderness, especially in the lower abdomen. Hydropneumoperitoneum or Retropneumoperitoneum or Hydroretropneumoperitoneum was reported on the abdomen and pelvic Computed Tomography (CT) scan with and without oral and intravenous contrast. The patient was diagnosed with intraperitoneal rectal perforation. He was then diagnosed with intraperitoneal rectal perforation and treated with intravenous antibiotics and surgery. After surgery, the patient's general condition improved and he was discharged without mortality and morbidity with the good condition after 6 days.
Conclusion: Hemorrhoidopexy with a stapler is more widely accepted than other hemorrhoidectomy methods especially manual methods for prolapse hemorrhoids due to less postoperative pain, shorter hospital stays, and faster return to work. Although this procedure usually has mild side effects that do not require surgery, sometimes life-threatening complications such as rectal perforation may happen, which requires prompt diagnosis and appropriate treatment.
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Type of Study: Case Report |

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