BMJ  2007;335:1260-1262 (15 December), doi:10.1136/bmj.39379.598090.AD

Practice

Rational Imaging

Investigating rectal bleeding

David Burling, consultant gastrointestinal radiologist 1, James E East, research fellow in endoscopy 2, Stuart A Taylor, senior lecturer3

1 Intestinal Imaging Centre, St Mark’s Hospital, Harrow HA1 3UJ, 2 Wolfson Unit for Endoscopy, St Mark’s Hospital, 3 Department of Specialist Radiology, University College Hospital, London NW1 2BU

Correspondence to: D Burling burlingdavid@yahoo.co.uk

Conventional colonoscopy is considered the optimal investigation for rectal bleeding; however, this article explores the use of virtual colonoscopy as a new investigative technique

The first 150 words of the full text of this article appear below.


  • Conventional colonoscopy is considered the optimal procedure for investigating rectal bleeding and is the only investigation that allows tissue removal, is widely available, and does not involve radiation
  • For some patients, virtual colonoscopy may be preferable as it is minimally invasive and convenient for patients and may also provide additional extracolonic information
  • Diagnostic virtual colonoscopy and therapeutic endoscopy can be complementary techniques
  • Close collaboration between endoscopy and radiology staff enables same day (single visit) virtual colonoscopy and conventional colonoscopy


An 83 year old man was referred to a surgical outpatient clinic by his general practitioner via the "two week wait" bowel cancer pathway for patients with persistent rectal bleeding (painless dark red blood with clots per rectum for one month with blood mixed in the stool) but no anal symptoms. He had had no weight loss or change in bowel habit, and except for hypertension, he was a fit non-smoker . . . [Full text of this article]


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