ROSH Gastrointestinal Practice Exam

What is the most appropriate management for an 83-year-old woman with a rectal mass?

1. Attempt manual reduction

2. Consultation to a colorectal surgeon

3. Immediately begin broad-spectrum antibiotics

4. Inject local anesthesia and perform an excisional thrombectomy

The correct answer is: Consultation to a colorectal surgeon

In the case of an 83-year-old woman with a rectal mass, consulting a colorectal surgeon is the most appropriate management option. This is because a rectal mass in an elderly patient raises significant concerns, including the possibility of malignancy or other serious conditions that require specialized evaluation. A colorectal surgeon has the expertise to perform necessary diagnostic procedures, such as a biopsy, imaging studies, or potentially surgical intervention, to determine the nature of the mass and the best course of action. The importance of such a referral cannot be overstated, as timely management and appropriate intervention can greatly affect outcomes in cases involving rectal masses. Additionally, given the patient's age and the potential complications associated with rectal masses, a thorough assessment by a specialist is essential for safe and effective care. Other management options may not address the underlying issue adequately. Manual reduction, for example, may be beneficial for certain conditions like rectal prolapse, but it is not appropriate for a mass that may have a different etiology. Initiating broad-spectrum antibiotics without a clear diagnosis could lead to unnecessary treatment, especially if the mass is neoplastic. Performing an excisional thrombectomy is not suitable, as it pertains to the management of hemorrhoids rather than a mass, which may require a