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]

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

## Contents

* 1 Epidemiology and Demographics
* 2 Differential Diagnosis
* 3 Diagnosis
* 3.1 History and Symptoms
* 3.2 Laboratory Findings
* 3.3 Echocardiography or Ultrasound
* 3.4 Other Diagnostic Studies
* 4 Treatment
* 4.1 Indications for Surgery
* 5 References
* 6 Acknowledgements

## Epidemiology and Demographics[edit | edit source]

Colorectal cancer

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

## Differential Diagnosis[edit | edit source]

In alphabetical order. [1] [2]

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

## Diagnosis[edit | edit source]

### History and Symptoms[edit | edit source]

* 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[edit | edit source]

* Labs include

* Fecal occult blood testing

### Echocardiography or Ultrasound[edit | edit source]

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

### Other Diagnostic Studies[edit | edit source]

* 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[edit | edit source]

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

### Indications for Surgery[edit | edit source]

* 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

## References[edit | edit source]

1. ↑ Sailer, Christian, Wasner, Susanne. Differential Diagnosis Pocket. Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:77 ISBN 1591032016
2. ↑ Kahan, Scott, Smith, Ellen G. In A Page: Signs and Symptoms. Malden, Massachusetts: Blackwell Publishing, 2004:68 ISBN 140510368X

## Acknowledgements[edit | edit source]

The content on this page was first contributed by Editor-In-Chief: C. Michael Gibson, M.S., M.D. [2]

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