Rectal bone bezoar: an unusual finding.

To cite: Kopke Túlio M, Barreiro P, Bana e Costa T, et al. BMJ Case Rep Published online: [please include Day Month Year] doi:10.1136/bcr-2016215232 DESCRIPTION A 60-year-old woman with an anxiety disorder presented with diarrhoea, rectorrhagia, tenesmus and proctalgia, progressively worsening for the past 2 months, in association with significant weight loss (15% body weight). Physical examination included a painful digital rectal examination, which identified a hard and spiculated mass immediately above the anal canal. Abdominopelvic X-ray showed a calcic-density 7 cm hypotransparent mass in the rectum. Evaluation by CT revealed a large, heterogeneous 72×44×43 mm bone density mass located in the rectal ampulla and associated with rectal wall thickening, in addition to several other small foci of calcium density, identified throughout the entire colon (figure 1). Rectosigmoidoscopy confirmed the presence of the mass consisting of multiple bird bones, mostly vertebrae, impacting on the rectum (figure 2). Using the anoscope and a Magill clamp, it was possible to remove, bone by bone, the entire rectal bezoar and multiple traumatic ulcerations of the rectal mucosa were identified (figure 2). Using the colonoscope, the entire colon was evaluated and the remaining bone fragments were removed.