Bowel obstruction due to metastatic sigmoid tumor

Case contributed by Bálint Botz


Obstipation, abdominal cramps. Colonoscopy showed sigmoid tumor, suspected liver metastases on US.

Patient Data

Age: 60 years
Gender: Male

Erect AP abdominal radiograph


Dilated descending colon, with distended small bowel loops accompanied by air-fluid levels, altogether findings are in line with subileus. 

Status post laparoscopic cholecystectomy. 

CT confirms a stenotising sigmoid tumor mass with resultant marked distension of the large and small bowel loops. Multiple air-fluid levels, indicating obstruction. There are multiple local and paraaortic pathological lymph nodes, demonstrating inhomogeneous enhancement and irregular borders. A small amount of intraperitoneal free fluid is best seen in the hepatorenal fossa and along the cecum. Multiple hypodense liver lesions pathognomonic for metastases. 

Other findings: status post cholecystectomy, left renal cysts, small hiatal hernia, degenerative skeletal changes. 

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