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

BackgroundCurrently, 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 presentationThis 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.ConclusionRectal 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.