A Case of Post-ALTA Hemorrhoid Therapy who Developed Severe Rectal Stenosis Due to Prolonged Total Circumferential Rectal Ulcer,in whom Frequent Balloon-dilatation Intervention was Effective

Abstract

A case was a 53-year-old male with hemorrhoid who underwent (4-stage) ALTA (aluminum potassium sulfate hydrate-tannic acid) injection therapy. Three weeks after the ALTA therapy he developed frequent mucous and bloody stool and was referred to us. Lower intestinal tract endoscopy revealed erosion and ulcer on the pectinate line and irregular-shaped multiple ulcers extending towards the rectosigmoidal junction. While the distal rectal erosion and ulcers healed relatively quickly, the proximal rectal and rectosigmoidal severe ulcers did not heal, and severe rectal stenosis developed at the proximal and distal sides of the ulcers. The patient suffered from frequent stool and difficulty in defecating. Although the circumferential ulcer at 7 cm from the anal verge (AV) for 5 cm in longitudinal length gradually healed, both ends of the ulcer lesion developed severe stenosis. We carried out balloon-dilatation intervention a total of 13 times over one year, and the ulcer healed and the patient's symptoms improved.