Rectal masses

Rectal masses
Colonoscopy: Rectum villous adenoma. Image courtesy of Professor Peter Anderson DVM PhD and published with permission © PEIR, University of Alabama at Birmingham, Department of Pathology

Template:Search infobox Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

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Masses in the rectum or anal canal should be considered cancer unless proven otherwise.

Epidemiology and Demographics

Colorectal cancer

• Second leading cause of mortality from cancer in the United States
• 40,000 death's/year

Differential Diagnosis

In alphabetical order.

• Anal cancer
• Endometriosis
• Foreign body
• Hemorrhoids
• Presacral neurogenic tumor
• Prostatitis
• Rectal Cancer
• Rectal polyp
• Rectal intussusception

Diagnosis

History and Symptoms

• History should include bowel changes and complete family history (focus on colorectal cancer)
• Bleeding is the most common symptom

• Stool or vomit black in color implies GI tract bleeding
• Blood on the toilet paper may indicate anal fissure or hemorrhoids
• Blood clots indicate bleeding in the colon

Laboratory Findings

• Labs include

• Fecal occult blood testing

Echocardiography or Ultrasound

• Endorectal ultrasound is essential to detecting potential rectal cancer
• Ultrasound is used to evaluate stage tumor invasion and lymph node status

Other Diagnostic Studies

• Endoscopy and/or colonoscopy
• Measuring the amount of pressure exerted by the anal sphincter via manometry may be necessary in patients suffering from incontinence

Treatment

• Rectal masses can be treated by radiation and/or chemotherapy

Indications for Surgery

• Rectal and anal cancers are treated by surgery
• Hemmorhoids - rubber band ligation for internal hemorrhoids
• Large refractroy hemmorrhoids - surgery is indicated
• Acute thrombosis of hemmorrhoid - incision and drainage

Acknowledgements

The content on this page was first contributed by Editor-In-Chief: C. Michael Gibson, M.S., M.D. [3]

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