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Peer-reviewedCC BYFrontiers in medicine

Case Report: Rectal perforation combined with presacral infection following rubber band ligation and sclerotherapy for hemorrhoids.

  • Yanqing Lu1
  • Ziwen Wang2
  • Zhenfu Shi3
  • Zhi Jiang4
  • Li Zhang4
  • Guolian Gan4
  • Zhen Zhou4
  • Hao Wang4
4 affiliations
  1. 1The Second Clinical Medical College of Guangzhou University of Chinese Medicine, Guangzhou, China.
  2. 2Department of Coloproctology, The Affiliated Guangzhou Hospital of TCM of Guangzhou University of Chinese Medicine, Guangzhou, China.
  3. 3Department of Proctology, Yinchuan Hospital of Traditional Chinese Medicine Affiliated to Ningxia Medicine University, Yinchuan, China.
  4. 4Department of Colorectal Surgery, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China.
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Abstract

Currently, rubber band ligation and injection sclerotherapy represent the first-line therapeutic strategy for grade I-III internal hemorrhoids. As an invasive procedure, it may still cause postoperative complications, among which, rectal perforation is one of the most serious complications. This paper describes a patient treated at our facility who experienced a rectal perforation and presacral infection following rubber band ligation and injection sclerotherapy. In the first stage, we performed laparoscopic double-barreled transverse colostomy combined with anal irrigation and anal dilatation to achieve fecal diversion and adequate drainage of the infectious focus. The patient achieved a satisfactory postoperative recovery. Stoma reversal was performed 6 months after surgery. Rectal perforation combined with presacral infection is a rare but severe complication of rubber band ligation and sclerotherapy for hemorrhoids, among these, sclerotherapy is the primary factor, while rubber band ligation is a contributing factor. It is mostly related to inappropriate iatrogenic operative manipulation. Clinically, strict standardization of rubber band ligation and injection sclerotherapy procedures is required, and close surveillance of high-risk patients after surgery should be strengthened to avoid complications and prevent delayed diagnosis and intervention.

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Cite

BibTeXRIS
BibTeX
@article{lu2026case,
  title = {{Case Report: Rectal perforation combined with presacral infection following rubber band ligation and sclerotherapy for hemorrhoids.}},
  author = {Yanqing Lu and Ziwen Wang and Zhenfu Shi and Zhi Jiang and Li Zhang and Guolian Gan and Zhen Zhou and Hao Wang},
  journal = {Frontiers in medicine},
  year = {2026},
  month = oct,
  doi = {10.3389/fmed.2026.1938366},
  url = {https://europepmc.org/article/MED/42952884},
  note = {CC BY},
}
RIS
TY  - JOUR
TI  - Case Report: Rectal perforation combined with presacral infection following rubber band ligation and sclerotherapy for hemorrhoids.
AU  - Yanqing Lu
AU  - Ziwen Wang
AU  - Zhenfu Shi
AU  - Zhi Jiang
AU  - Li Zhang
AU  - Guolian Gan
AU  - Zhen Zhou
AU  - Hao Wang
PY  - 2026
DA  - 2026/10/14
JO  - Frontiers in medicine
DO  - 10.3389/fmed.2026.1938366
UR  - https://europepmc.org/article/MED/42952884
AB  - Currently, rubber band ligation and injection sclerotherapy represent the first-line therapeutic strategy for grade I-III internal hemorrhoids. As an invasive procedure, it may still cause postoperative complications, among which, rectal perforation is one of the most serious complications. This paper describes a patient treated at our facility who experienced a rectal perforation and presacral infection following rubber band ligation and injection sclerotherapy. In the first stage, we performed laparoscopic double-barreled transverse colostomy combined with anal irrigation and anal dilatation to achieve fecal diversion and adequate drainage of the infectious focus. The patient achieved a satisfactory postoperative recovery. Stoma reversal was performed 6 months after surgery. Rectal perforation combined with presacral infection is a rare but severe complication of rubber band ligation and sclerotherapy for hemorrhoids, among these, sclerotherapy is the primary factor, while rubber band ligation is a contributing factor. It is mostly related to inappropriate iatrogenic operative manipulation. Clinically, strict standardization of rubber band ligation and injection sclerotherapy procedures is required, and close surveillance of high-risk patients after surgery should be strengthened to avoid complications and prevent delayed diagnosis and intervention.
SN  - 2296-858X
ER  -