Massive hemorrhage in pregnancy caused by a diffuse cavernous hemangioma of the rectum--EUS as imaging modality of choice.

Hemorrhoidal bleeding is common during pregnancy. Other preexisting anorectal conditions can also be exacerbated by the increased vascular volume and pelvic congestion. We present the case of a young woman who developed life-threatening rectal bleeding requiring early delivery.

Anorectal sepsis and fistula-in-ano.

Anorectal abscesses and fistulas are common maladies that are usually readily diagnosed and effectively treated. However, complex fistulous disease challenges even the most expert of surgical specialists. The management options in this subset of patients are suboptimal, with treatment often requiring multiple procedures, putting the patient at risk for continued symptoms and fecal incontinence.

Ulcerative colitis: the fate of the retained rectum.

Ileal pouch-anal anastomosis has clearly diminished the role of colectomy and ileorectal anastomosis (IRA) in the management of patients with ulcerative colitis. Nonetheless, IRA probably still has an appropriate place in highly selected patients, and many others maintain an "out of circuit" rectal remnant after subtotal colectomy. Although symptomatic proctitis is the most common reason for completion proctectomy, these patients are also at a significant risk to develop rectal cancer.