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Rectal ischemia causes mass formation, masquerading as rectal cancer
Fotios Fousekis1, Panagiota Aggeli1, Spyridon Gkogkos2
1Department of Gastroenterology and Endoscopy Unit, Filiates General Hospital, Filiates 46300, Greece.
Rectal ischemia is rare but can mimic rectal cancer on endoscopy. Prompt diagnosis of this
Area of Science:
- Gastroenterology
- Colorectal Surgery
- Pathology
Background:
- Rectal ischemia is uncommon due to the rectum's rich vascular supply.
- Ischemic colitis can present atypically, mimicking malignant neoplasms.
- Endoscopic visualization of ischemic colitis is often non-specific.
Observation:
- A case of rectal ischemia presented with hematochezia and a large, ulcerating mass obscuring the rectal lumen.
- The mass was initially suspected to be rectal cancer during proctoscopy.
- Histological examination revealed ischemic colitis, not malignancy.
Findings:
- Conservative treatment led to the complete resolution of the ulcerated mass within 10 days.
- Follow-up biopsies confirmed the initial diagnosis of ischemic colitis.
- The 'mass-forming' presentation of ischemic colitis resolved completely with conservative management.
Implications:
- Highlights the importance of considering 'mass-forming' ischemic colitis in the differential diagnosis of rectal masses.
- Emphasizes the need for accurate diagnosis to guide appropriate treatment and prevent complications.
- Early recognition can prevent unnecessary surgical interventions for suspected rectal cancer.
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