To analyze the clinical and imaging features of the various emergent rectal pathologies.
To illustrate through imaging cases the most common (and uncommon) rectal emergencies and its complications.
To make a review of the protocols for acquisition and major indications of Computed Tomography (CT) imaging in these cases and to discuss the indications of endorectal contrast in the post-surgical rectal evaluation.
Patients with rectal pathologies may have acute symptoms that can either be similar or indistinctive from other abdominal emergencies. Due to this overlap of manifestations,
CT may play both primary and complementary roles in evaluating these pathologies.
An early diagnose plays a crucial role in avoiding dreaded complications,
therefore it is important for the radiologists to recognize the imaging signs, so they are able to correlate the findings in order to make an accurate diagnose and to identify the associated aggravations.
Findings and procedure details
The rectum is the concluding part of the large intestine that terminates in the anus. Its average length may range between 10 and 15 cm.
The course of the rectum is marked by two major flexures:
Sacral flexure: anteroposterior curve with concavity anteriorly.
Anorectal flexure: anteroposterior curve with convexity anteriorly.
There are additionallythree lateral flexures (superior,
intermediate and inferior),
which are formed by transverse folds of the internal rectum wall.
Peritoneal Coverings: Fig. 1
In the superior third of the rectum,
There are several conditions that affect the rectum as an emergency.
It is important to know the anatomy of the rectum and the main radiological features of rectal emergencies,
as well as knowing radiological techniques and types of contrast materials,
in order to maximize resources and get the right diagnosis.
CT has an essential role in evaluating these pathologies.
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