Rare rectal mucocele mimic tumor following hemorrhoidectomy in an adult patient.

Mucoceles are commonly associated with the appendix and cranial sinuses. Rectal mucoceles are rare. There are case reports of rectal mucoceles following Hartmann’s procedure, and secon dary to high anal sphincter tone following spinal trauma. [1,2] Mucoceles have developed in defunctioned colon after pull-through surgery due to stenosis and retraction of the colonic stump [3,4]. Scarring of the mucus fistula, or failure to create a mucus fistula are other described contributing factors. We report a case of small rectal mucoceles following hemorrhoidectomy which caused scarring and stricture of the anal canal. A 39-year-old male with a history of hemorrhoidectomy 4 years ago presented tenesmus and difficult in defecation for half a year. Due to persisted and troublesome symptoms he visited our clinic. The digital examination showed two palpable mass and irregular surface of anal canal. The anal scopy was done and rectal tumor was suspected. On admission, the laboratory examinations and the colonoscopy were done for evaluation of the operation. The colonoscopy showed two small tumors located in 6 and 10 o’clock direction and anal cannel scar (Fig. 1). The operation of wide excision and revision of anal cannel scar was performed. The pathological result showed mucocele with benign colorectal glands floating in mucin pool (Fig. 2). After surgical treatment the symptoms were improved a lot and no evidence of recurrent mucocele is for 9 months. Mucin secretion is produced by mucosal cell. Mucocele is difficult to form in the gastrointestinal tract except appendix due to its often obstruction. Mucous retention is an important Fig. 1. Colonoscopic pictures showed that tumor mass in the rectum (black arrow).