Investigating PR bleeding (summary)

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This is a basic article for medical students and other non-radiologists

Investigating PR bleeding radiologically may help to make a diagnosis or give more information after a diagnosis has been established. Radiology should not replace appropriate physical examination or appropriate use of sigmoidoscopy and colonoscopy.

Reference article

This is a summary article; we do not have a more in-depth reference article.

Summary

  • questions
    • history of the bleeding
    • associated bowel habit change
    • associated weight change
  • investigations
    • AXR
      • may be helpful if there is associated large bowel obstruction
      • however, rarely of much use and additional radiation
    • CT abdomen/pelvis
      • post-contrast examination
      • general assessment of the abdomen and pelvis
      • assessment of bowel wall and bowel dilatation
      • tumors can often be seen on CT, although not always
    • CT colonoscopy
      • used as virtual colonoscopy to find polyps and tumors
        • increasing sensitivity
        • advantage over colonoscopy: less uncomfortable
        • disadvantage: no biopsy
    • MRI fistula study
      • used in patients with Crohns who have fistula
    • MRI rectum
      • used in the specific scenario of staging rectal carcinoma
  • making the request
    • know the question that the team needs answered
    • know the patient's renal function if contrast is needed
    • know examination findings
    • know the results of other tests
  • common pathology
Medical student radiology curriculum