This is a basic article for medical students and other non-radiologists
Investigating PR bleeding radiologically may help to make a diagnosis or give more information after a diagnosis has been established. Radiology should not replace appropriate physical examination or appropriate use of sigmoidoscopy and colonoscopy.
Reference article
This is a summary article; we do not have a more in-depth reference article.
Summary
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questions
- history of the bleeding
- associated bowel habit change
- associated weight change
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investigations
- AXR
- may be helpful if there is associated large bowel obstruction
- however, rarely of much use and additional radiation
- CT abdomen/pelvis
- post-contrast examination
- general assessment of the abdomen and pelvis
- assessment of bowel wall and bowel dilatation
- tumors can often be seen on CT, although not always
- CT colonoscopy
- used as virtual colonoscopy to find polyps and tumors
- increasing sensitivity
- advantage over colonoscopy: less uncomfortable
- disadvantage: no biopsy
- used as virtual colonoscopy to find polyps and tumors
- MRI fistula study
- used in patients with Crohns who have fistula
- MRI rectum
- used in the specific scenario of staging rectal carcinoma
- AXR
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making the request
- know the question that the team needs answered
- know the patient's renal function if contrast is needed
- know examination findings
- know the results of other tests
- common pathology