Rectal ischemia causes mass formation, masquerading as rectal cancer

Abstract

Rectal ischemia rarely occurs because of the rich vascular supply of the rectum, while endoscopic presentation of ischemic colitis always is not distinct and can uncommonly mimic malignant neoplasm. We present a case of a rectal ischemia, which presented with haematochezia and proctoscopy revealed a large ulcerating mass, masquerading as rectal cancer and obstructed the lumen of rectum. However, histological examinations showed only features for ischemic colitis and no evidence for malignancy. The patient was treated conservatively and 10 days later, new endoscopy showed complete disappearance of ulcerated mass, and new biopsies confirmed the initial diagnosis. Awareness and early diagnosis of ‘mass forming’ entity of ischemic colitis is very essential in order to carry out appropriate treatment and avoid severe complications.

Rectal necrosis in the setting of critical illness and burn

“…Such injuries have been reported to have been treated conservatively with only one requiring interval resection and anastomosis due to stricture. Rectal ischemia in the setting of known ischemic colitis is rare and reported to be around 2–5% [ 10 ]. On our review, there are no case reports of rectal trauma due to direct thermal injury.…”

Mass-Forming Ischemic Colitis: A Potential Mimicker of Malignancy

“…IC accounts for 50–60% of all gastrointestinal ischemic episodes, most often in the absence of major vessel occlusion [2, 3]. Clinically IC most commonly presents acutely with abdominal pain, hematochezia, and diarrhea, with more serious complications such as fever, perforation, peritonitis, and septic shock developing dependent on the duration and extent of colonic injury [4]. Often, the diagnosis can be made utilizing clinical, radiologic, colonoscopic, and mucosal biopsy findings; however, there have been reports of atypical pathologic manifestations, precluding the diagnosis [5].…”