ﮔﺰارش ﯾﮏ ﻣﻮرد آدﻧﻮﮐﺎرﺳﯿﻨﻮم رﮐﺘﻮم در ﯾﮏ دﺧﺘﺮ ﻫﺸﺖ ﺳﺎﻟﻪ و ﺗﺸﺨﯿﺺ ﻧﺎدرﺳﺖ اﺳﻬﺎل ﻋﻔﻮﻧﯽ

Rectal Adenocarcinoma Misdiagnosed with Infectious Diarrhea in an 8 Year Old Girl

آدﻧﻮﮐﺎرﺳﯿﻨﻮم رﮐﺘﻮم در ﮐﻮدﮐﺎن ﻧﺎدر اﺳﺖ. ﺑﯿﻤﺎري ﮐﻪ در اﯾﻦ ﻧﻮﺷﺘﺎر ﮔﺰارش ﻣﯽﺷﻮد ﺑﺎ رﮐﺘﻮراژي ﺑﻪ ﺑﯿﻤﺎرﺳﺘﺎن ﻣﺮاﺟﻌﻪ ﮐﺮده ﺑﻮد. ﻣﺸﮑﻞ ﺑﯿﻤﺎر از ﺳﻪ ﻣﺎه ﻗﺒﻞ ﺷﺮوع ﺷﺪه و در اﯾﻦ ﻣﺪت ﺑﺎ ﺗﺸﺨﯿﺺ اﺳﻬﺎل ﻋﻔﻮﻧﯽ درﻣﺎن ﺷﺪه اﺳﺖ. ﺳﻪ ﻣﺎه ﺑﻌﺪ از ﺷﺮوع ﻋﻼﯾﻢ، ﺑﯿﻤﺎر در ﺑﯿﻤﺎرﺳﺘﺎن ﻣﺎ ﮐﻮﻟﻮﻧﻮﺳﮑﭙﯽ ﺷﺪه، ﭘﻮﻟﯿﭗ ﺑﺪون ﭘﺎﯾﻪ دﯾﺪه و ﺧﺎرج ﺷﺪ. ﭘﺲ از ﮐﻮﻟﻮﻧﻮﺳﮑﭙﯽ ﻧﺸﺎﻧﻪﻫﺎي ﭘﺮﯾﺘﻮﻧﯿﺖ ﺑﻮﺟﻮد آﻣﺪ. ﭘﺲ از ﻻﭘﺎروﺗﻮﻣﯽ ﺟﺮاج ﻣﺘﻮﺟﻪ ﮔﺮدﯾﺪ ﮐﻪ ﭘﺮﻓﻮراﺳﯿﻮن رﮐﺘﻮم رخ داده و از ﻣﺨﺎط رﮐﺘﻮم ﺑﯿﻮﭘﺴﯽ ﺑﺮداﺷﺘﻪ ﺷﺪ. ﻧﺘﯿﺠﻪ ﺑﯿﻮﭘﺴﯽ آدﻧﻮﮐﺎرﺳﯿﻨﻮم رﮐﺘﻮم ﺑﻮد و در ﻧﺘﯿﺠﻪ رزﮐﺴﯿﻮن ﻗﺪاﻣﯽ و ﭘﺎﯾﯿﻦ رﮐﺘﻮم ﺑﺎ اﯾﻠﯿﻮﺳﺘﻮﻣﯽ و ﻫﻤﭽﻨﯿﻦ ﺷﯿﻤﯽ درﻣﺎﻧﯽ اﻧﺠﺎم ﺷﺪ. در ﭘﯿﮕﯿﺮي ﭘﺎﻧﺰده ﻣﺎﻫﻪ ﺣﺎل ﻋﻤﻮﻣﯽ ﺑﯿﻤﺎر ﺧﻮب ﺑﻮده و ﻧﺸﺎﻧﻪاي از ﺑﺎزﮔﺸﺖ ﺑﯿﻤﺎري در ﺑﺮرﺳﯽﻫﺎي ﺑﺎﻟﯿﻨﯽ، آزﻣﺎﯾﺸﮕﺎﻫﯽ و رادﯾﻮﻟﻮژﯾﮏ دﯾﺪه ﻧﺸﺪ. ﮔﺮﭼﻪ آدﻧﻮﮐﺎرﺳﯿﻨﻮم رﮐﺘﻮم ﻧﺎدر اﺳﺖ و ﺑﺎﯾﺪ در ﺗﺸﺨﯿﺺﻫﺎي اﻓﺘﺮاﻗﯽ ﻣﺸﮑﻼت روده در ﻧﻈﺮ ﺑﺎﺷﺪ.

We present an 8-year-old girl presented with rectorrhagia that started since 3 months and misdiagnosed with infectious diarrhea. A few months later, colonoscopy revealed a non-pedunculated polyp and was resected. After the colonoscopy the patient had presentations of peritonitis and rectal perforation was noted in laparotomy. The result of rectal biopsy was adenocarcinoma. Surgery consultant decided to perform a low anterior resection of rectum, ileostomy and the treatment continued with chemotherapy. After 19 month’s follow-ups the patient was alright without any clinical, radiological or laboratory signs or symptoms of tumoral recurrence. As the manifestations of rectal adenocarcinoma are not specific, the clinicians should consider it in the differential diagnosis of gastrointestinal problems.