Rectal masses
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.
Epidemiology and Demographics
Epidemiology and Demographics
Colorectal cancer
- Second leading cause of mortality from cancer in the United States
- 40,000 death’s/year
Differential Diagnosis
Differential Diagnosis
In alphabetical order. [1] [2]
- Anal cancer
- Endometriosis
- Foreign body
- Hemorrhoids
- Presacral neurogenic tumor
- Prostatitis
- Rectal Cancer
- Rectal polyp
- Rectal intussusception
Diagnosis
Diagnosis
History and Symptoms
- 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
- Labs include
- Fecal occult blood testing
Echocardiography or Ultrasound
- Endorectal ultrasound is essential to detecting potential rectal cancer
- Ultrasound is used to evaluate stage tumor invasion and lymph node status
Other Diagnostic Studies
- 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
Treatment
- Rectal masses can be treated by radiation and/or chemotherapy
Indications for Surgery
- 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
References
Acknowledgements
Acknowledgements
The content on this page was first contributed by Editor-In-Chief: C. Michael Gibson, M.S., M.D. [2]
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