An irregular ulcer in the rectumBMJ 2021; 372 doi: https://doi.org/10.1136/bmj.n316 (Published 18 February 2021) Cite this as: BMJ 2021;372:n316
- Qiang Wang, professor of dermatology1,
- Ji-Na Zheng, dermatology postgraduate1,
- Jian-Min Xu, professor of surgery2,
- Yun-Shi Zhong, professor of surgery2
- 1Department of Dermatology, Zhongshan Hospital, Fudan University, Shanghai, China
- 2Department of Surgery, Zhongshan Hospital, Fudan University, Shanghai, China
- Correspondence to Q Wang
A man in his 50s was referred to hospital by his general practitioner with a suspected rectal lesion after rectal examination. He had also experienced intermittent constipation without rectal pain for five years, which he had managed with self-administered simple enemas once a week for the past three years, but these were not effective at relieving the constipation. He had a medical history of intolerance to penicillin. Full details of his sexual history could not be elicited.
Digital rectal examination showed a non-tender rectal lesion of about 3 cm in diameter on the left side of the rectum; it had a smooth base, was slightly raised, and had indurated borders.
Relevant laboratory test results are shown in table 1.
Magnetic resonance imaging showed irregular low rectal wall thickening (about 4 cm …