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Thrombosed hemorrhoid mimicking rectal carcinoma at CT
1Department of Medicine, Hadassah University Hospital, Jerusalem, Israel.
Acta Radiologica (Stockholm, Sweden : 1987)
|September 1, 1992
Summary
Large hemorrhoids can mimic rectal tumors on CT scans in patients with portal hypertension. This case highlights the importance of considering hemorrhoids in the differential diagnosis to avoid misdiagnosis.
Area of Science:
- Gastroenterology and Radiology
- Diagnostic Imaging
- Hepatology
Background:
- Portal hypertension, a complication of cirrhosis, can lead to anorectal abnormalities.
- Rectal tumors are a significant concern in patients presenting with lower pelvic pain.
- Computed Tomography (CT) is a key imaging modality for evaluating rectal pathology.
Observation:
- A 46-year-old male with cirrhosis and portal hypertension presented with lower pelvic pain.
- CT imaging suggested a rectal tumor, prompting further investigation.
- Physical examination and endoscopic procedures failed to confirm a tumor, but identified large hemorrhoids.
Findings:
- Large thrombosed hemorrhoids were present and had been noted prior to the CT scan.
- The CT findings suggestive of a rectal tumor were ultimately attributed to the hemorrhoids.
- This discrepancy highlights a potential pitfall in CT interpretation.
Implications:
- Hemorrhoids, particularly large or thrombosed ones, should be considered in the differential diagnosis of suspected rectal tumors on CT.
- Integrating clinical history, physical examination, and imaging findings is crucial for accurate diagnosis.
- This underscores the importance of a comprehensive diagnostic approach in patients with portal hypertension and pelvic symptoms.