Rectal Ischemia Mimicked Tumor Mass
Ischemic proctitis is a rare disease which is usually encountered in elderly with comorbidities. We present a case of an 80-year old man with severe coronary disease who presented with severe hematochezia and hypotension. Endoscopy revealed a rectal mass 3-4 cm above the dental line and rectosigmoid...
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| Format: | Article |
| Language: | English |
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Wiley
2013-01-01
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| Series: | Case Reports in Gastrointestinal Medicine |
| Online Access: | http://dx.doi.org/10.1155/2013/853825 |
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| author | Nicolaos Zikos Panagiota Aggeli Evangelia Louka George Pappas-Gogos |
| author_facet | Nicolaos Zikos Panagiota Aggeli Evangelia Louka George Pappas-Gogos |
| author_sort | Nicolaos Zikos |
| collection | DOAJ |
| description | Ischemic proctitis is a rare disease which is usually encountered in elderly with comorbidities. We present a case of an 80-year old man with severe coronary disease who presented with severe hematochezia and hypotension. Endoscopy revealed a rectal mass 3-4 cm above the dental line and rectosigmoid mucosal inflammation compatible with ischemic colitis. The rectal insult was so intense that it resembled a neoplasmatic lesion. We discuss the causes, the prognostic factors, and the clinical and therapeutic challenges of this rare, albeit life-threatening entity, and we review the relative literature. A percentage of 10%–20% of patients with ischemic colitis usually have a distal potentially obstructing lesion or disorder such as cancer, diverticulitis or fecal impaction. Ischemic colitis, when mucosal and submucosal edema is severe and hemorrhagic nodules are large enough, can mimic a neoplasmatic lesion. The best treatment approach is a conservative management initially with a close clinical followup and after stabilization a repetition of rectal endoscopy with new biopsies. Early recognition of this clinical entity is of paramount importance to implement appropriate therapy (conservative or surgical) and avoid potentially fatal treatment of presumed inflammatory or infectious bowel diseases. |
| format | Article |
| id | doaj-art-a537f48676ef4d5a8ccde7622c4cbaa9 |
| institution | Kabale University |
| issn | 2090-6528 2090-6536 |
| language | English |
| publishDate | 2013-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Gastrointestinal Medicine |
| spelling | doaj-art-a537f48676ef4d5a8ccde7622c4cbaa92025-02-03T06:01:06ZengWileyCase Reports in Gastrointestinal Medicine2090-65282090-65362013-01-01201310.1155/2013/853825853825Rectal Ischemia Mimicked Tumor MassNicolaos Zikos0Panagiota Aggeli1Evangelia Louka2George Pappas-Gogos3Department of Surgery, Filiates General Hospital, 29 Kapodistriou, 1a Nizna, Filiates, 45332 Ioannina, GreeceDepartment of Gastroenterology, Filiates General Hospital, Eleftheriou & Kavafi, Filiates, 46100 Igoumenitsa, GreeceDepartment of Pathology, Filiates General Hospital, 99-101 G. Papandreou, N. Philadelphia, 14342 Athens, GreeceDepartment of Surgery, Filiates General Hospital, 29 Kapodistriou, 1a Nizna, Filiates, 45332 Ioannina, GreeceIschemic proctitis is a rare disease which is usually encountered in elderly with comorbidities. We present a case of an 80-year old man with severe coronary disease who presented with severe hematochezia and hypotension. Endoscopy revealed a rectal mass 3-4 cm above the dental line and rectosigmoid mucosal inflammation compatible with ischemic colitis. The rectal insult was so intense that it resembled a neoplasmatic lesion. We discuss the causes, the prognostic factors, and the clinical and therapeutic challenges of this rare, albeit life-threatening entity, and we review the relative literature. A percentage of 10%–20% of patients with ischemic colitis usually have a distal potentially obstructing lesion or disorder such as cancer, diverticulitis or fecal impaction. Ischemic colitis, when mucosal and submucosal edema is severe and hemorrhagic nodules are large enough, can mimic a neoplasmatic lesion. The best treatment approach is a conservative management initially with a close clinical followup and after stabilization a repetition of rectal endoscopy with new biopsies. Early recognition of this clinical entity is of paramount importance to implement appropriate therapy (conservative or surgical) and avoid potentially fatal treatment of presumed inflammatory or infectious bowel diseases.http://dx.doi.org/10.1155/2013/853825 |
| spellingShingle | Nicolaos Zikos Panagiota Aggeli Evangelia Louka George Pappas-Gogos Rectal Ischemia Mimicked Tumor Mass Case Reports in Gastrointestinal Medicine |
| title | Rectal Ischemia Mimicked Tumor Mass |
| title_full | Rectal Ischemia Mimicked Tumor Mass |
| title_fullStr | Rectal Ischemia Mimicked Tumor Mass |
| title_full_unstemmed | Rectal Ischemia Mimicked Tumor Mass |
| title_short | Rectal Ischemia Mimicked Tumor Mass |
| title_sort | rectal ischemia mimicked tumor mass |
| url | http://dx.doi.org/10.1155/2013/853825 |
| work_keys_str_mv | AT nicolaoszikos rectalischemiamimickedtumormass AT panagiotaaggeli rectalischemiamimickedtumormass AT evangelialouka rectalischemiamimickedtumormass AT georgepappasgogos rectalischemiamimickedtumormass |