An Unusual Case of Rectal Bleed in an Adolescent: Solitary Rectal Ulcer Syndrome Mimicking Rectosigmoid Malignancy

Abstract

Solitary Rectal Ulcer Syndrome (SRUS) is an uncommon rectal disorder. Severe rectal bleeding, anaemia and a mass on evaluation are a rare presentation of SRUS, and can pose as an endoscopic challenge in differentiating from other causes of rectal bleeding. The incidence of SRUS is 1 in 100,000 people per year. Hence, a high degree of suspicion and timely diagnosis is necessary. The present case is about a 17-year-old female who presented with rectal bleeding. Physical evaluation revealed a large polypoidal rectal mass mimicking malignancy which later turned out to be SRUS. The patient improved with medical management. On outpatient follow-up, she had no complaints after a month and follow-up lower endoscopy and imaging later revealed complete healing within three months. Although uncommon, SRUS should be considered as a potential cause of lower gastrointestinal bleeding after sinister causes have been ruled out.

Keywords

• endoscopy
• female
• lower gastrointestinal bleed