Thickening of the rectal wall

[corky13]

Hi there. I recently had a abd/pelvic ct with and without contrast done. I have been having pain in the right side just above the buttock. I have also been experiencing nausea that seems to come and go. I can have it daily for a week and it not return for a month. I do not experience numerous watery loose stools, but I do have loose stools that are not well formed when I have a bowel movement. I usually have a one bowel movement a day, but can skip 2 or 3 days in a row. I have noticed mucus in the stool on occasion.

The results of the ct scan are as follows:
Thickening of the rectal wall, nonspecific in appearance. The possibility of proctitis must be considered. Direct examination may be appropriate.
There is some free fluid in the pelvis
Also, there is a low-density focus in the anterior aspect of the right kidney likely representing a small cyst and small low -density lesions in the left kidney, likely representing cysts. There is no retroperitoneal adenopathy.
The GI tract appears normal. The pancreas, liver, and spleen have a normal appearance.

I had a sigmoidoscopy in September of 07.

Here are my questions.

1. Can a ct. scan indicate proctitis with some degree of accruacy?
2. How likely is this thickening of the rectal wall indicitive of cancer?
3.What types of tests will my gastroenterologist want to do to examine the rectal wall thickening?
4. Could rectal cancer have developed since my sigmoid done last year?
5. What other causes could there be for rectal wall thickening?

Thank you for your time in advance.

[cheeks917]

I have a question?. I had a colonoscopy in august 2010. Found a polyp. Doctor removed sent in for biopsy. Had a tiny bit of cancer was sent to a butt doctor. He taylor the spot then went i for surgery and he took around it out. Went in 3 months co up and st scan fine. Then cea blood work first blood work wentfrom 1.5 to 3 then 3 mo's later to 6. Then doctor sent me for a cat scan. Liver and abdominal came back fine. Pet scan fine. Checked rectum fine. Now he says there is a little thickening of the rectum wall and since my cea is up from 1.5 to 3 to 6 since las august. He is sending me for a mri.  What is your prognosis on this

[corky13]

Thank you for your quick response. I just have a couple more questions in response to your answers.

1. First, I thought the sigmoidoscopy was the same thing as a colonoscopy except that it doesn't reach through the transverse and ascending colon. Is that correct? And if that is true wouldn't the sigmoidoscopy that I had last year have viewed the rectal wall which is in question?
2. If cancer was in any way a possibiltiy would it have stated that on the report?
3. Would the lower right sided back pain be related to this in any way?

[Kevin Pho, MD]

1) Yes, a CT scan can be reasonably accurate in the diagnosis of proctitis.  A colonoscopy will be more definitive and more comprehensive than a sigmoidoscopy.

2) Cancer is possible, a colonoscopy is the next step.

3) See above, a colonoscopy with possible biopsy.

4) That would be unlikely, but I cannot say the chances are zero.

5) Colitis and gastroenteritis would be the other causes of wall thickening.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
www.kevinmd.com