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Bowel obstruction from colon carcinoma

Case contributed by David Cuete
Diagnosis almost certain

Presentation

Abdominal pain.

Patient Data

Age: 40 years
Gender: Male

CT abdomen and pelvis

ct

CT shows a concentric segmental thickening of the colon wall at the level of the hepatic flexure about 7 cm in length, that progressively enhances after contrast administration and is associated with dilated proximal small bowel, having mild submucosal edema.  Normal contrast enhancement pattern. Multiple lymph nodes at the root of the mesentery, meso-colic and intercavoaortic up to 11 mm, probably of a secondary nature. Displays at least six hypovascular lesions in the posterior segment of the right lobe of liver which presents progressive enhancement using contrast medium, compatible with secondary lesions.

Case Discussion

This case shows concentric wall thickening in the hepatic flexure, compatible with primary epithelial tumor  associated with mechanical ileus of the right colon and proximal small bowel. Retroperitoneal and mesenteric lymphadenopathy, probably secondary. Omental and peritoneal implants adjacent to the rectum is associated with mild ascites, consistent with peritoneal carcinomatosis. Multiple secondary focal liver lesions

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