Solitary rectal ulcer syndrome (SRUS) is an uncommon condition that presents with non-specific symptoms shared by other disease processes. This case report shares a unique presentation in which a patient was thought to have fistulous perianal Crohn's disease then underwent treatment with infliximab but was ultimately found to have SRUS. The prognosis and treatment of SRUS vary greatly from inflammatory bowel disease. Making the correct diagnosis is imperative when considering Crohn's disease and its mimickers.

Mesothelioma is a difficult-to-detect neoplasm that rarely develops in the peritoneum. In patients with unexplained ascites, pleural fluid analysis and ultrasonography is often the first step to achieving a diagnosis. This case report shares a unique presentation in which a patient who presented with unexplained ascites, was initially thought to have cirrhosis but was later found to have malignant peritoneal mesothelioma after cross-sectional imaging and tissue acquisition. This case illustrates the importance of a high clinical index of suspicion for mesothelioma given its variety of clinical presentations, as well as the utility of early cross-sectional imaging in such cases.