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A single case of vascular ecstasia involving the upper rectum and manifesting as an ulcerative lesion is reported. This is the first report of such a case. The authors emphasize the importance of exploratory laparotomy and careful histologic studies in diagnosting such cases.

I In nt tr ro od du uc ct ti io on n A bū Bakr Muḥammad ibn Zakariyyā al-Rāzī (died 313 AH/925 CE), known to Europeans as Rhazes, earned a great reputation as an eminent surgeon of his time. His students compiled his notes into a book entitled al-Ḥāwī fī al-ṭibb (The Comprehensive Book on Medicine). 1 Al-Ḥāwī was repeatedly mentioned centuries later in the texts written by Ibn Sīnā (died 428 AH/1037 CE) 2 and ibn al-Quff al-Karakī (died 685 AH/1286 CE). 3 It also reached Europe. According to the U.S. National Libray of Medicine: It was translated into Latin in 1279 under the title Continens by Faraj ben Salīm, a physician of Sicilian-Jewish origin employed by Charles of Anjou to translate medical works, and it had considerable influence in Europe as well as in the Islamic world. 4This paper will summarize al-Rāzī's writings on anorectal disease to demonstrate that its surgical treatment was well-recognized and treated with utmost care and diligence. Al-Rāzī's text deals with the treatment of hemorrhoids, incontinence, fissures, rectal prolapse, ulcers, itching, abscesses, solid swelling, and fistulas. S So ou ur rc ce es s a an nd d M Me et th ho od do ol lo og gy yThe primary source used for this paper is Kitāb alḥāwī fī al-ṭibb. Al-Ḥāwī, in its modern, incomplete printed version, fills 23 volumes. 1,5 `Alī ibn al-`Abbās al-Majūsī wrote that its enormous size precluded its duplication and circulation and criticized its lack of organization. According to Emilie Savage-Smith, ibn al-`Amid, the wazīr (minister) of the Buwayhid ruler Rukn al-Dawla, arranged in 327 AH/939 CE for al-Rāzī's pupils after his death to compile his notes into the volume that came to be al-Ḥāwī. 5 Savage-Smith wrote:The Hawi is an extremely important source for knowledge of Greek, Indian, and early Arabic writings now lost, for al-Rāzī was meticulous about crediting his sources. Moreover the clinical cases, while not unique, are the most numerous and varied in the Islamic medieval medical literature. The material comprising the Hawi is arranged under the headings of different diseases, with separate sections on pharmacological topics. 5 T Tr re ea at tm me en nt t o of f A An no or re ec ct ta al l D Di is se ea as se es s b by y a al l--R Rā āz zī ī