GI Radiography


Case 14 :
A 65-year-old male, a chronic smoker, presents with acute obstruction. CT scan is performed.
What is the diagnosis?

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Findings

CT shows haemoperitonuem, penumoperitoneum, and a constricting mass lesion in the sigmoid colon (Fig 3). Dilated large bowel, with thinning of the wall is noted, with mesenteric and omental inflammatory changes.

Diagnosis
Sigmoid growth with large bowel gangrene

 Discussion
CT is now a routine preoperative modality for patients with colorectal neoplasms. Colorectal neoplasms usually appear as a focal area of thickening of the bowel wall. As opposed to wall thickening seen in non-neoplastic diseases, the luminal surface appears irregular and lobulated. Sometimes, applecore appearance (on air-insufflation method) or intra-luminal polypoidal lesions are seen. Complications of neoplasms such as obstruction, perforation and intussusception are readily detected on CT.

Net Links
http://webmd-practice.webmd.com/frame/asset/sas_chapters_08_0806
http://www.bhj.org/journal/2000_4202_apr00/sp_282.htm 

 Dr. Sanjeev Mani, Mumbai