{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T18:15:24Z","timestamp":1790014524269,"version":"4.0.1"},"reference-count":13,"publisher":"BMJ","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Gut"],"published-print":{"date-parts":[[1996,4]]},"abstract":"<jats:p>BACKGROUND--The aetiology and pathology of rectal prolapse and solitary rectal ulcer are poorly understood. AIMS--To examine the full thickness rectal wall in these two conditions. METHODS--The pathological abnormalities in the surgically resected rectal wall were studied from nine patients with solitary rectal ulcer syndrome, 11 complete rectal prolapse, and nine cancer controls. Routine haematoxylin and eosin and Van Gieson staining for collagen were performed. RESULTS--The rectal wall from solitary rectal ulcer syndrome specimens was thickened compared with complete rectal prolapse and controls. The major difference was in the muscularis propria (2.2 v 1.1 v 1.2 mm, medians, p &lt; 0.005) and particularly the inner circular muscular layer, and to a lesser extent the submucosal and outer longitudinal muscular layers. Some solitary rectal ulcer syndrome specimens showed unique features such as decussation of the two muscular layers (four of nine), nodular induration of inner circular layer (four of nine) and grouping of outer longitudinal layer into bundles (three of nine); these were not seen in complete rectal prolapse or control specimens. CONCLUSIONS--These features, which resemble the features of high pressure sphincter tissue, may be of aetiological importance, and suggest a different pathogenesis for these two disorders. Excess collagen was seen in both disorders, was more severe in solitary rectal ulcer syndrome specimens, and probably reflects a response to repeated trauma.<\/jats:p>","DOI":"10.1136\/gut.38.4.587","type":"journal-article","created":{"date-parts":[[2007,9,18]],"date-time":"2007-09-18T17:41:31Z","timestamp":1190137291000},"page":"587-590","source":"Crossref","is-referenced-by-count":49,"title":["Pathology of the rectal wall in solitary rectal ulcer syndrome and complete rectal prolapse."],"prefix":"10.1136","volume":"38","author":[{"given":"Y S","family":"Kang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M A","family":"Kamm","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A F","family":"Engel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"I C","family":"Talbot","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[1996,4,1]]},"reference":[{"issue":"10","key":"ref_1","first-page":"871","article-title":"Solitary ulcer of the rectum","volume":"1969","author":"Madigan, M.R.; Morson, B.C.","unstructured":"Madigan MR, Morson BC. Solitary ulcer of the rectum. Gut 1969; 10: 871-81.","journal-title":"Gut"},{"key":"ref_2","first-page":"282","article-title":"Solitary ulcer syndrome of the rectum: its relation to mucosal prolapse","volume-title":"the pelvic floor. Pathophysiology and management","author":"Rutter, K.R.P.","year":"1985","unstructured":"Rutter KRP. Solitary ulcer syndrome of the rectum: its relation to mucosal prolapse. In: Henry MM, Swash M, eds. Coloproctology and the pelvic floor. Pathophysiology and management. London: Butterworths, 1985: 282-98."},{"key":"ref_3","first-page":"985","article-title":"The pathogenesis and pathophysiology of rectal prolapse and solitary rectal ulcer syndrome","volume":"15","author":"Mackle, E.J.; Parks, T.G.","year":"1986","unstructured":"Mackle EJ, Parks TG. The pathogenesis and pathophysiology of rectal prolapse and solitary rectal ulcer syndrome. Glin Gastroenterol 1986; 15: 985-1002.","journal-title":"Glin Gastroenterol"},{"key":"ref_4","article-title":"Rectal prolapse and the solitary ulcer syndrome","author":"Nicholls, R.J.","year":"1994","unstructured":"Nicholls RJ. Rectal prolapse and the solitary ulcer syndrome. In: Kamm MA, Lennard-Jones JE, eds. Constipation. Petersfield, UK: Wrightson Biomedical Publishing, 1994."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"505","DOI":"10.1016\/S0300-5089(21)00249-2","article-title":"The solitary ulcer syndrome of the rectum","volume":"4","author":"Rutter, K.R.P.; Riddell, R.H.","year":"1975","unstructured":"Rutter KRP, Riddell RH. The solitary ulcer syndrome of the rectum. Clin Gastroenterol 1975; 4: 505-30.","journal-title":"Clin Gastroenterol"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1228","DOI":"10.1136\/gut.28.10.1228","article-title":"Pressure and prolapse - the cause of solitary rectal ulceration","volume":"28","author":"Womack, N.R.; Williams, N.S.; Holmfield, J.H.M.; Morrison, J.F.B.","year":"1987","unstructured":"Womack NR, Williams NS, Holmfield JHM, Morrison JFB. Pressure and prolapse - the cause of solitary rectal ulceration. Gut 1987; 28: 1228-33.","journal-title":"Gut"},{"key":"ref_7","first-page":"1533","article-title":"Clinical spectrum of solitary ulcer syndrome","volume-title":"of the rectum. Gastroenterology 1983; 84","author":"Ford, M.J.; Anderson, JR, Gilmour; HM, Holt; S, Sircus; W, Heading; R.C.","unstructured":"Ford MJ, Anderson JR, Gilmour HM, Holt S, Sircus W, Heading RC. Clinical spectrum of solitary ulcer syndrome of the rectum. Gastroenterology 1983; 84: 1533-40."},{"issue":"129","key":"ref_8","first-page":"1225","article-title":"The surgical treatment of rectal procidentia","volume":"1969","author":"Frykman, H.M.; Goldberg, S.M.","unstructured":"Frykman HM, Goldberg SM. The surgical treatment of rectal procidentia. Surg Gynecol Obstet 1969; 129: 1225-30.","journal-title":"Surg Gynecol Obstet"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1422","DOI":"10.1136\/gut.34.10.1422","article-title":"Transrectal ultrasound study of the pathogenesis of solitary rectal ulcer syndrome","volume":"34","author":"MJ, Van Outryve; PA, Pelckmans; H, Fierens; YM, Van Maercke","year":"1993","unstructured":"Van Outryve MJ, Pelckmans PA, Fierens H, Van Maercke YM. Transrectal ultrasound study of the pathogenesis of solitary rectal ulcer syndrome. Gut 1993; 34: 1422-6.","journal-title":"Gut"},{"key":"ref_10","first-page":"313","article-title":"The large intestine","volume-title":"Systemic pathology: alimentary tract. Vol 3","author":"Jass, JR","year":"1987","unstructured":"Jass JR. The large intestine. In: Morson BC, ed. Systemic pathology: alimentary tract. Vol 3. 3rd ed. Edinburgh: Churchill Livingstone, 1987: 313-95.","edition":"3rd ed"},{"key":"ref_11","first-page":"847","article-title":"Surgical correction of rectal procidentia","volume":"62","author":"Devadhar, D.S.C.","year":"1967","unstructured":"Devadhar DSC. Surgical correction of rectal procidentia. Surgery 1967; 62: 847-52.","journal-title":"Surgery"},{"key":"ref_12","first-page":"213","article-title":"Pathology of idiopathic megarectum and megacolon","author":"Gattuso, J.M.; Talbot, I.C.; Kamm, M.A.","year":"1994","unstructured":"Gattuso JM, Talbot IC, Kamm MA. Pathology of idiopathic megarectum and megacolon. In: Kamm MA, Lennard-Jones JE, eds. Constipation. Petersfield, UK: Wrightson Biomedical Publishing, 1994: 213-8."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"330","DOI":"10.1007\/BF02616986","article-title":"Procidentia of the rectum studied with cineradiography: a contribution to the discussion of causative mechanism","volume":"11","author":"Broden, B.; Snellman, B.","year":"1968","unstructured":"Broden B, Snellman B. Procidentia of the rectum studied with cineradiography: a contribution to the discussion of causative mechanism. 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