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Gastroenterology514 papers

Rectal hematoma

Last edited: 4/23/2026

Overview

Rectal hematoma refers to bleeding into the rectal wall, often caused by trauma or anticoagulation therapy, leading to localized swelling and potential complications such as pain, obstruction, or infection. 25

Diagnosis

  • Clinical presentation includes rectal pain, palpable mass, and bleeding.
  • Imaging studies (CT, MRI) are crucial for assessing the extent and complications 25.
  • Colonoscopy may be necessary to rule out other causes like tumors 25.
  • Management

  • Immediate cessation of anticoagulants if applicable.
  • Conservative management with bed rest, pain control, and monitoring for complications.
  • Surgical intervention may be required for large hematomas, persistent bleeding, or complications like abscess formation 25.
  • Special Populations

  • No specific guidelines provided for pregnancy, pediatrics, or elderly patients in the abstracts reviewed.
  • Key Recommendations

  • Imaging for assessment: Utilize CT or MRI to evaluate the extent and complications of rectal hematoma 25.
  • Anticoagulant management: Temporarily discontinue anticoagulants if the patient is on them 25.
  • Conservative vs. Surgical Approach: Tailor management based on hematoma size and presence of complications; surgical intervention is indicated for severe cases 25.
  • (Evidence: Moderate)

    References

    Showing 100 most recent of 172 indexed papers.

    1 Wo JY, Ashman JB, Bhadkamkar NA, Bradfield L, Chang DT, Hanna N et al.. Radiation Therapy for Rectal Cancer: An ASTRO Clinical Practice Guideline Focused Update. Practical radiation oncology 2025. link 2 Korngold EK, Kambadakone AR, Berlin J, Cash BD, Dane B, Hanna N et al.. ACR Appropriateness Criteria® Staging and Disease Monitoring of Rectal Cancer. Journal of the American College of Radiology : JACR 2025. link 3 Benson AB, Venook AP, Adam M, Chang G, Chen YJ, Ciombor KK et al.. NCCN Guidelines® Insights: Rectal Cancer, Version 3.2024. Journal of the National Comprehensive Cancer Network : JNCCN 2024. link 4 Bedrikovetski S, Traeger L, Seow W, Dudi-Venkata NN, Selva-Nayagam S, Penniment M et al.. Oncological Outcomes and Response Rate After Total Neoadjuvant Therapy for Locally Advanced Rectal Cancer: A Network Meta-Analysis Comparing Induction vs. Consolidation Chemotherapy vs. Standard Chemoradiation. Clinical colorectal cancer 2024. link 5 Ágústsdóttir DH, Öberg S, Christophersen C, Oggesen BT, Rosenberg J. The Frequency of Urination Dysfunction in Patients Operated on for Rectal Cancer: A Systematic Review with Meta-Analyses. Current oncology (Toronto, Ont.) 2024. link 6 Wang X, Li J, Chen W, Yang Q. Preserving the left colonic artery in radical sigmoid and rectal cancer surgery is feasible: A meta-analysis. Medicine 2024. link 7 Anker CJ, Tchelebi LT, Selfridge JE, Jabbour SK, Akselrod D, Cataldo P et al.. Executive Summary of the American Radium Society on Appropriate Use Criteria for Nonoperative Management of Rectal Adenocarcinoma: Systematic Review and Guidelines. International journal of radiation oncology, biology, physics 2024. link 8 Koskenvuo L, Lunkka P, Varpe P, Hyöty M, Satokari R, Haapamäki C et al.. Morbidity After Mechanical Bowel Preparation and Oral Antibiotics Prior to Rectal Resection: The MOBILE2 Randomized Clinical Trial. JAMA surgery 2024. link 9 Liang X, Chi F. Simple, Rapid, Safe, and Cost-Effective Technique for Rectal Washout During Laparoscopic Surgery for Rectal Cancer. Journal of the College of Physicians and Surgeons--Pakistan : JCPSP 2024. link 10 Arici MO, Avsar E, Kilic O, Salim DK. Leukocytoclastic vasculitis associated with capecitabine. Journal of oncology pharmacy practice : official publication of the International Society of Oncology Pharmacy Practitioners 2024. link 11 Nougaret S, Rousset P, Lambregts DMJ, Maas M, Gormly K, Lucidarme O et al.. MRI restaging of rectal cancer: The RAC (Response-Anal canal-CRM) analysis joint consensus guidelines of the GRERCAR and GRECCAR groups. Diagnostic and interventional imaging 2023. link 12 Noh YK, Lee J, Kim SJ. Technique, sedation, and clinical outcome of endoscopic submucosal dissection for rectal tumor with involvement of dentate line: A retrospective cohort study. Saudi journal of gastroenterology : official journal of the Saudi Gastroenterology Association 2023. link 13 Mizukami S, Shonaka T, Tani C, Ihara K, Takeda T, Ohara M et al.. A case of percutaneous transhepatic stomal varices embolization and partial splenic artery embolization for rectal cancer after CAPOX/BEV chemotherapy: the summary of the stomal varices related to oxaliplatin administration. Clinical journal of gastroenterology 2023. link 14 Vendrely V, Rivin Del Campo E, Modesto A, Jolnerowski M, Meillan N, Chiavassa S et al.. Rectal cancer radiotherapy. Cancer radiotherapie : journal de la Societe francaise de radiotherapie oncologique 2022. link 15 Surov A, Pech M, Powerski M, Woidacki K, Wienke A. Pretreatment Apparent Diffusion Coefficient Cannot Predict Histopathological Features and Response to Neoadjuvant Radiochemotherapy in Rectal Cancer: A Meta-Analysis. Digestive diseases (Basel, Switzerland) 2022. link 16 Piqeur F, Hupkens BJP, Nordkamp S, Witte MG, Meijnen P, Ceha HM et al.. Development of a consensus-based delineation guideline for locally recurrent rectal cancer. Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology 2022. link 17 Cribb BI, Kong J, McCormick J, Warrier SK, Heriot AG. Functional outcomes after lateral pelvic lymph node dissection for rectal cancer: a systematic review and meta-analysis. International journal of colorectal disease 2022. link 18 Chi F, Lan Y, Zhou S. Difficult Defecation Caused by a Huge Rectal Leiomyoma. Journal of the College of Physicians and Surgeons--Pakistan : JCPSP 2022. link 19 Deskur-Śmielecka E, Sopata M, Chojnicki M, Sopata M. Gastrointestinal fistula with thigh extension and intractable pain. BMJ supportive & palliative care 2022. link 20 Fahy MR, Kelly ME, Power Foley M, Nugent TS, Shields CJ, Winter DC. The role of intraoperative radiotherapy in advanced rectal cancer: a meta-analysis. Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland 2021. link 21 Wo JY, Anker CJ, Ashman JB, Bhadkamkar NA, Bradfield L, Chang DT et al.. Radiation Therapy for Rectal Cancer: Executive Summary of an ASTRO Clinical Practice Guideline. Practical radiation oncology 2021. link 22 Cheong JY, Shin SH, Kim J, Kim SH. Novel technique in atraumatic retraction for minimally invasive low anterior resection. ANZ journal of surgery 2021. link 23 Hisamatsu Y, Kuriyama N, Fujimoto Y, Jogo T, Hu Q, Hokonohara K et al.. Indications for laparoscopic surgery for older rectal cancer patients with comorbidities. Surgery today 2021. link 24 Kolahi KS, Nakano M, Kuo CJ. Organoids as Oracles for Precision Medicine in Rectal Cancer. Cell stem cell 2020. link 25 Mauravičiūtė S, Dulskas A. Treatment Strategies for Massive Presacral Bleeding. Diseases of the colon and rectum 2020. link 26 Sho S, Yothers G, Colangelo LH, Ganz PA, O'Connell MJ, Beart RW et al.. Assessing the Quality of Rectal Cancer Pathology Reports in National Surgical Adjuvant Breast and Bowel Project Protocol R-04/NRG Oncology. Diseases of the colon and rectum 2020. link 27 Yasuda T, Tanaka O, Hayashi S, Nakahata Y, Yasuda Y, Omatsu T et al.. Successful treatment of unresectable advanced rectal cancer with liver metastases by hemostasis re-irradiation of the rectal cancer and palliative low-dose whole-liver radiation therapy: a case report. Clinical journal of gastroenterology 2020. link 28 Ewongwo A, Hamidi M, Alattar Z, Ayotunde OP, Tiwari HA, Elquza E et al.. Contributing factors and short-term surgical outcomes of patients with early-onset rectal cancer. American journal of surgery 2020. link 29 Ryan DP. The Increasingly Complicated Approach to Rectal Cancer. The oncologist 2019. link 30 Christou N, Meyer J, Toso C, Ris F, Buchs NC. Lateral lymph node dissection for low rectal cancer: Is it necessary?. World journal of gastroenterology 2019. link 31 Geessink OGF, Baidoshvili A, Klaase JM, Ehteshami Bejnordi B, Litjens GJS, van Pelt GW et al.. Computer aided quantification of intratumoral stroma yields an independent prognosticator in rectal cancer. Cellular oncology (Dordrecht, Netherlands) 2019. link 32 Saunders S, Anwar M. Capecitabine-induced myopericarditis - A case report and review of literature. Journal of oncology pharmacy practice : official publication of the International Society of Oncology Pharmacy Practitioners 2019. link 33 Goto S, Hida K, Hoshino N, Hisamori S, Kawada K, Sakurai T et al.. Laparoscopic rectal tumor surgery after administration of a new sclerosing therapy (aluminum potassium sulfate and tannic acid injection) for internal hemorrhoids: A report of three cases. Asian journal of endoscopic surgery 2019. link 34 Thiptanakit C, Chowchankit I, Panya S, Kanjanasilp P, Malakorn S, Pattana-Arun J et al.. Urgent Pelvic Exenteration: Should the Indication Be Extended?. Diseases of the colon and rectum 2018. link 35 Keane C, Lin AY, Kramer N, Bissett I. Can pathological reports of rectal cancer provide national quality indicators?. ANZ journal of surgery 2018. link 36 Guadagni S, Clementi M, Bencivenga M, Kusamura S, Fiorentini C, Masedu F. Palliation with a multimodality treatment including hypoxic pelvic perfusion for unresectable recurrent rectal cancer: outcomes based on a retrospective study. Updates in surgery 2018. link 37 Sammour T, Chang GJ. Robotic surgery for rectal cancer: the future?. Minerva chirurgica 2018. link 38 Nishino M, Okano M, Kawada J, Kim Y, Yamada M, Tsujinaka T. Well-leg compartment syndrome after laparoscopic low anterior resection for lower rectal cancer in the lithotomy position: A case report. Asian journal of endoscopic surgery 2018. link 39 Takemoto Y, Harada E, Takeuchi Y, Kawamura D, Suehiro Y, Kugimiya N et al.. Laparoscopic low anterior resection for rectal cancer after Whitehead's hemorrhoidectomy: A case report. Asian journal of endoscopic surgery 2018. link 40 Lee ES, Kim MJ, Park SC, Hur BY, Hyun JH, Chang HJ et al.. Magnetic Resonance Imaging-Detected Extramural Venous Invasion in Rectal Cancer before and after Preoperative Chemoradiotherapy: Diagnostic Performance and Prognostic Significance. European radiology 2018. link 41 Jäger T, Neureiter D, Urbas R, Klieser E, Hitzl W, Emmanuel K et al.. Applicability of American Joint Committee on Cancer and College of American Pathologists Regression Grading System in Rectal Cancer. Diseases of the colon and rectum 2017. link 42 Watanabe T, Hata K. Robotic surgery for rectal cancer with lateral lymph node dissection. The British journal of surgery 2016. link 43 Kluza E, Kleijnen JP, Martens MH, Rennspiess D, Maas M, Jeukens CR et al.. Non-invasive MR assessment of macroscopic and microscopic vascular abnormalities in the rectal tumour-surrounding mesorectum. European radiology 2016. link 44 Harji DP, Griffiths B, Velikova G, Sagar PM, Brown J. Systematic review of health-related quality of life issues in locally recurrent rectal cancer. Journal of surgical oncology 2015. link 45 Simunovic MR, DeNardi FG, Coates AJ, Szalay DA, Eva KW. Product analysis and initial reliability testing of the total mesorectal excision-quality assessment instrument. Annals of surgical oncology 2014. link 46 Lee KM, Lim SG, Shin SJ, Kim JH, Kang DH, Kim JK et al.. Novel method of stent insertion for malignant lower rectal obstruction with proximal releasing delivery system (with video). Gastrointestinal endoscopy 2013. link 47 Chatu S, Kumar D, Du Parcq J, Vlahos I, Pollok R. A rare cause of rectal bleeding masquerading as proctitis. Journal of Crohn's & colitis 2013. link 48 Mylona S, Karagiannis G, Patsoura S, Galani P, Pomoni M, Thanos L. Palliative treatment of rectal carcinoma recurrence using radiofrequency ablation. Cardiovascular and interventional radiology 2012. link 49 Stottmeier S, Harling H, Wille-Jørgensen P, Balleby L, Kehlet H. Postoperative morbidity after fast-track laparoscopic resection of rectal cancer. Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland 2012. link 50 Kodeda K, Derwinger K, Gustavsson B, Nordgren S. Local recurrence of rectal cancer: a population-based cohort study of diagnosis, treatment and outcome. Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland 2012. link 51 Li J, Fang Y, Li A, Li F. Breast metastases from rectal carcinoma. Chinese medical journal 2011. link 52 Oh SY, Kim YB, Paek OJ, Suh KW. Does total mesorectal excision require a learning curve? Analysis from the database of a single surgeon's experience. World journal of surgery 2011. link 53 Fernández-Esparrach G, Ayuso-Colella JR, Sendino O, Pagés M, Cuatrecasas M, Pellisé M et al.. EUS and magnetic resonance imaging in the staging of rectal cancer: a prospective and comparative study. Gastrointestinal endoscopy 2011. link 54 Sugimoto A, Haga M, Motohashi S, Takahashi Y, Kanazawa H, Nakazawa S. A case of rectal obstruction caused by bilateral internal iliac artery aneurysms. Annals of vascular surgery 2011. link 55 Faus C, Roda D, Frasson M, Roselló S, García-Granero E, Flor-Lorente B et al.. The role of the pathologist in rectal cancer diagnosis and staging and surgical quality assessment. Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico 2010. link 56 Cappell MS. Universal lessons learned by a gastroenterologist from a deaf and mute patient: the importance of nonverbal communication and establishing patient rapport and trust. American annals of the deaf 2009. link 57 Olszyna-Serementa M, Kołodziejczyk M, Sprawka A, Nasierowska-Guttmejer A, Bujko K. The quality of pathological reports of postoperative specimens in rectal cancer: an audit from the Mazovia region. Polish journal of pathology : official journal of the Polish Society of Pathologists 2009. link 58 Wang JJ, Yuan HS, Li JN, Jiang WJ, Jiang YL, Tian SQ. Interstitial permanent implantation of 125I seeds as salvage therapy for re-recurrent rectal carcinoma. International journal of colorectal disease 2009. link 59 Mukai M, Fukasawa M, Kishima K, Iizuka S, Fukumitsu H, Yazawa N et al.. Trans-anal reinforcing sutures after double stapling for lower rectal cancer: report of two cases. Oncology reports 2009. link 60 Rabau M. Transanal resection of rectal neoplasms using the Harmonic Scalpel. 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Endoscopic trans-anal resection of rectal tumours: critical appraisal of an interdisciplinary approach. Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland 2007. link 66 Currarino G. Neonatal subperiosteal cephalohematoma crossing a synostosed sagittal suture. Pediatric radiology 2007. link 67 Lewinshtein D, McCormack M, Péloquin F, Poljicak M, Karakiewicz P, Saad F. Recto-cavernosal fistula after radiation for rectal cancer. The Canadian journal of urology 2006. link 68 Eon Y, Le Douy JY, Lamer B, Battini J, Bretagne JF. Quality and completeness of histopathology reports of rectal cancer resections. Results of an audit in Brittany. Gastroenterologie clinique et biologique 2006. link73159-1) 69 Pollack J, Holm T, Cedermark B, Altman D, Holmström B, Glimelius B et al.. Late adverse effects of short-course preoperative radiotherapy in rectal cancer. The British journal of surgery 2006. link 70 Påhlman L. 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