Mucocele complicating stapled hemorrhoidopexy

Area of Science:

• Colorectal Surgery
• Gastroenterology

Background:

• Stapled hemorrhoidopexy is a common procedure for rectal prolapse.
• Complication rates range from 12.7% to 36.4%, necessitating awareness for prompt management.

Purpose of the Study:

• To report a rare case of mucocele formation following stapled hemorrhoidopexy.
• To highlight diagnostic methods and treatment for this uncommon complication.

Main Methods:

• A 57-year-old female presented with perineal discomfort, anal spasm, and tenesmus two years post-stapled hemorrhoidopexy.
• Diagnostic tools included physical examination and 3D 360° transanal ultrasound, revealing a pararectal fluid collection.
• Surgical intervention involved draining mucus via a transanal approach.

Main Results:

• The patient experienced significant relief and became asymptomatic after surgical mucocele drainage.
• Follow-up demonstrated normal defecation and complete resolution of symptoms.

Conclusions:

• Mucocele is a rare, often delayed complication of stapled hemorrhoidopexy, potentially presenting as a rectal pocket.
• Differential diagnosis from other pararectal lesions like abscesses can be challenging.
• Transanal surgical drainage is the preferred treatment for symptomatic mucoceles, leading to favorable outcomes.