I’m new here, and I am looking for some help understanding a recent MRI. After surgery for a rectocle, I had a follow-up MRI Defecography to see if the surgery resolved some or most of my issues with defecation (physically I could tell it had not). The MRI revealed a number of changes from the prior MRI just 11 months before. Most notably, the radiologist newly noted “Focal thickening of the sigmoid colon.” Per Dr. Google, that is frequently caused by cancer. Has anyone had experience with this finding? I don’t have a colonoscopy until February 8th, and this MRI was in December (for a variety of reasons, it has taken a long time to get the colonscopy scheduled). Any insights would be helpful.
Here is my 12/2017 MRI Summary:
IMPRESSION:
1. Focal thickening of the sigmoid colon may be related to prior surgery with colocolic anastomosis. If there is no surgical history, consider short-term interval follow-up or further evaluation with colonoscopy. (I have no related surgical history)
2. Interval curvilinear material in rectovaginal space consistent with post-surgical changes.
3. Moderate cystocele.
4. Mild vaginal prolapse.
5. Normal levator hiatus and normally positioned anorectal junction at rest with severe widening of the levator hiatus and severe descent of the anorectal junction during defecation/maximal strain.
6. Large peritoneocele containing redundant sigmoid colon.
7. Moderate rectocele
8. Full thickness intraanal intussusception of the anterior and lateral walls of the rectum.
9. Normal resting anorectal/levator-anus angle that demonstrates expected widening with defecation and expected narrowing with Kegel.
Subset of detailed findings:
Anatomic Evaluation: Status post hysterectomy. There is a 3.7 cm left adnexal cyst. Per ACR white paper guidelines, no follow-up is needed for a cyst of this size in a premenopausal patient.. The levator ani muscles are symmetric. Sigmoid colon is
redundant with a focal area of thickening in the upper part of the sigmoid colon (series 3, image 6). New curvilinear hypointensity in the rectovaginal compartment likely sequela of prior surgery.
1/2017 MRI Summary
IMPRESSION:
1. Status post hysterectomy.
2. Featureless visualized large bowel possibly related to chronic use of laxatives.
3. Grade 1 cystocele with excessive urethral hypermobility.
4. Grade 1 vaginal prolapse
5. Normal levator hiatus and low lying anorectal junction at rest with grade 2 widening of the levator hiatus and grade 2 descent of the anorectal junction during defecation/maximal strain.
6. Large enterocele.
7. Moderate rectocele.
8. No rectal intussusception.
9. Normal resting anorectal/levator-anus angle that demonstrates excessive widening with defecation and expected narrowing with Kegel.
Thanks in advance for your help!