1. Constipation, pain, and
blood-stained rectal drainage
A 56-year-old man presented to
the emergency department with a
history of constipation, abdominal
pain, and blood-stained mucus
drainage from the rectum. The patient
had no fever; vital signs were
stable. A vague fullness was felt in the
lower abdomen. Rectal examination
revealed anal warts; a patulous anal
sphincter; and a smooth, mobile, firm
mass above the dentate line.
Abdominal films showed a smoothly marginated, cylindrical tubular filling defect that projected toward the lower abdominal and pelvic regions, with the long axis in a craniocaudal orientation.
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