CASE 108

History: A 38-year-old woman presents with chronic constipation and recent rectal bleeding.

1. Which of the following should be included in the differential diagnosis of the imaging finding shown in the figure? (Choose all that apply.)

A. Hemorrhoids

B. Endometriosis

C. Peritoneal metastases

D. Colitis cystica profunda

E. Rectal adenocarcinoma

2. On defecography, what finding may be evident in this patient?

A. Rectocele

B. Enterocele

C. Pelvic floor prolapse

D. Internal rectal prolapse

3. Which of the following statements regarding clinical aspects of solitary rectal ulcer syndrome is true?

A. It is mainly a disease of women.

B. A quarter of patients may be asymptomatic.

C. Patients usually present within 3 months of onset of symptoms.

D. The most common presentation is a feeling of incomplete evacuation.

4

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