Rectal adenocarcinoma presenting as full-thickness prolapse with external haemorrhoids: case report

We present a case of a 51-year-old male with a colonic adenocarcinoma that presented as a full-thickness rectal prolapse with external haemorrhoids. This patient had no significant medical or surgical history and presented to the emergency department with a rectal prolapse which had become incarcerated and increasingly painful over the previous 2 weeks. A computed tomography (CT) abdomen and pelvis appeared benign, demonstrating a full-thickness rectal prolapse with no definite rectal mass. A colonoscopy was performed, revealing anterior rectal mucosal edema, fibrosis, and a possible mass. This prompted the patient to be taken to the operating room for a low anterior resection of the rectum and sigmoid. A 10.5 × 8.2 × 1.9 cm rectal mass was noted and pathology revealed colonic adenocarcinoma. This case highlights the importance of performing a colonoscopy in patients with atypical rectal prolapse, even when the physical exam and CT appears benign.