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Subocclusive symptoms, tenesmus and rectal bleeding

Author: Riccardo Ferrari, Pasquale Paolantonio, Graziano Pernazza, Vito Pende, Riccardo Di Segni, Azienda Ospedaliera "San Giovanni-Addolorata", Rome, Italy
Body Region: CT Colonography

1. Patient presentation
2. CT Images
3. CT Findings
4. Diagnosis
5. References

1. Patient presentation

  • A 21-year-old man reported subocclusive symptoms and pain in the left flank. He also described the sensation of something protruding from the anus after straining, as well as tenesmus and rectal bleeding.
  • In a surgical visit, a possible lesion was detected at digital rectal exploration.
  • Optical colonoscopy was incomplete due to the presence, 40 cm from the anus, of a large, soft, quite mobile and occluding mass. Contrast-enhanced magnetic resonance imaging revealed a large intraluminal rectal lesion with a high content of fat tissue. In particular, the T2-weighted fast spin echo (FSE) sagittal image showed the lesion with a long stalk.
  • CT colonography was performed to confirm the diagnosis and to study the remaining colonic segments.