Work

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

Year: 2026

Type: article

Abstract: Background: 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. Case presentation: 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. Conclusion: 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.

Source: Frontiers in Medicine

DOI: 10.3389/fmed.2026.1938366