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Rectal Pain and the Colonic Crunch Sign.

Mahmood SK - ACG Case Rep J (2015)

View Article: PubMed Central - PubMed

Affiliation: Department of Gastroenterology, Lahey Clinic, Burlington, MA.

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Vital signs were stable on presentation and bedside physical examination revealed a non-tender abdomen... Laboratory work was only significant for leukocytosis of 17,000 cells/μL... Digital rectal exam revealed a “crunchy” mass... The patient underwent flexible sigmoidoscopy with visualization of a large clump of sunflower seeds (Figure 2), but it was not possible to remove them with either the water jet or snare net... He underwent colonoscopy under general anesthesia, resulting in complete evacuation... On colonoscopy, mucosal erythema and edema was noted at site of seed impaction, which appeared secondary to irritation from the bezoar... The patient was advised to avoid ingesting sunflower seeds and was discharged home... Digital rectal exam in the presence of a phytobezoar can sometimes reveal a crunchy mass of seeds at the anal verge, dubbed as the “colonic crunch” sign... Author contributions: S... Mahmood procured the images, wrote the manuscript, and is the article guarantor... Financial disclosure: None to report... Informed consent was obtained for this case report.

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Rectal phytobezoar shown on abdominal X-ray.
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Figure 1: Rectal phytobezoar shown on abdominal X-ray.

Mentions: Laboratory work was only significant for leukocytosis of 17,000 cells/μL. Abdominal X-ray (Figure 1) suggested rectal fecal loading. Digital rectal exam revealed a “crunchy” mass. The patient underwent flexible sigmoidoscopy with visualization of a large clump of sunflower seeds (Figure 2), but it was not possible to remove them with either the water jet or snare net. He underwent colonoscopy under general anesthesia, resulting in complete evacuation. On colonoscopy, mucosal erythema and edema was noted at site of seed impaction, which appeared secondary to irritation from the bezoar. The remainder of examined colon to cecum appeared normal, without any stricture, polyp, or mass. The patient was advised to avoid ingesting sunflower seeds and was discharged home.


Rectal Pain and the Colonic Crunch Sign.

Mahmood SK - ACG Case Rep J (2015)

Rectal phytobezoar shown on abdominal X-ray.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4508938&req=5

Figure 1: Rectal phytobezoar shown on abdominal X-ray.
Mentions: Laboratory work was only significant for leukocytosis of 17,000 cells/μL. Abdominal X-ray (Figure 1) suggested rectal fecal loading. Digital rectal exam revealed a “crunchy” mass. The patient underwent flexible sigmoidoscopy with visualization of a large clump of sunflower seeds (Figure 2), but it was not possible to remove them with either the water jet or snare net. He underwent colonoscopy under general anesthesia, resulting in complete evacuation. On colonoscopy, mucosal erythema and edema was noted at site of seed impaction, which appeared secondary to irritation from the bezoar. The remainder of examined colon to cecum appeared normal, without any stricture, polyp, or mass. The patient was advised to avoid ingesting sunflower seeds and was discharged home.

View Article: PubMed Central - PubMed

Affiliation: Department of Gastroenterology, Lahey Clinic, Burlington, MA.

AUTOMATICALLY GENERATED EXCERPT
Please rate it.

Vital signs were stable on presentation and bedside physical examination revealed a non-tender abdomen... Laboratory work was only significant for leukocytosis of 17,000 cells/μL... Digital rectal exam revealed a “crunchy” mass... The patient underwent flexible sigmoidoscopy with visualization of a large clump of sunflower seeds (Figure 2), but it was not possible to remove them with either the water jet or snare net... He underwent colonoscopy under general anesthesia, resulting in complete evacuation... On colonoscopy, mucosal erythema and edema was noted at site of seed impaction, which appeared secondary to irritation from the bezoar... The patient was advised to avoid ingesting sunflower seeds and was discharged home... Digital rectal exam in the presence of a phytobezoar can sometimes reveal a crunchy mass of seeds at the anal verge, dubbed as the “colonic crunch” sign... Author contributions: S... Mahmood procured the images, wrote the manuscript, and is the article guarantor... Financial disclosure: None to report... Informed consent was obtained for this case report.

No MeSH data available.


Related in: MedlinePlus