Fluid around rectum

[MIMI7]

I have fluid around my rectum diagnosed by sonogram in Jan 08 and by CT June 08.  The fluid amount is greater on the CT.  The CT was then followed by a CT-guided drainage of "pelvic" fluid, which after two attempts could not yield any fluid.  I have had two bouts of terrific abdominal pain, one in April and one just before the CT, that lasted two days each.  My internal med doctor felt that originally it might be kidney stones vs liver disease vs diverticulitis.  He started me on Cipro with this last bout of pain which I have stopped due to stomach upset.  I will meet with my doctor and then probably his choice for a surgeon next week, 7/2.  In January since I was not having any pain in my back or violent symptoms the fluid pocket was written off as a shadow of my coccyx.  Then when I had the CT last week and the fluid pocket was bigger, the concern grew.  There is a thought that it might be a diverticulum that burst because of contrast material being in this fluid.  I basically eat healthy and rarely eat greasy food.  However, my mom did have diverticulitis and ulcerative colitis for many years with medication.  Due to this limited information, what do you think and what would you recommend?

[boron]

If contrast was found outside the gut, then rectum should be examined carefully to find the leak, since perforated intestine may lead to peritonitis. Hard to be smart here, I guess your doctors know what they are doing. My guess is that you need colonoscopy (or sigmoidoscopy) to see exactly what is happening.

[lizziecee]

The fluid could be from a fistula in the large colon......this is fairly common in Ulcerative Colitis and Crohn's disease.  A colonoscopy should be the next step to view the colon and take biopsies. I don't think a sigmoidoscopy will  go far enough up the colon. Hopefully when you see your doctor 7.2 (he is a gastro, isn't he, not just a general physician?) he will be able to order further invasive testing for a definitive diagnosis.

Take care.
Liz.

[MIMI7]

Thank you for your input.  I had a colonoscopy 2 years ago which only showed diverticulosis...mild at that...and basically was normal.  My doctor is an internal medicine doctor.  The radiologist who did this last procedure to try to drain the fluid said that the reason he couldn't draw any fluid out was the fluid kept moving.  My mom had diverticulitis and ulcerative colitis that was severe because she let it go for so long before doing anything about it.  Her father died of colon cancer.  I appreciate your support and have a few more ideas to throw into the stew pot.

[boron]

Colorectal cancer usually starts as a polyp, which is clearly seen in endoscopy. Building of fluid around the rectum is not a sign of a cancer, but a rather a sign of inflammation.