Changes in bowel habits for a long time and right lower abdominal pain with mass felt in the right iliac fossa.
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A short annular constricting lesion of mid-segment of the ascending colon causing obliteration of the lumen and is obstructing the upstream ascending colon, cecum, and small bowel. There is surrounding fat stranding with multiple regional enlarged lymph nodes. If this lesion were seen on barium enema, it would have an apple core appearance.
The liver is average in size and density with a hypodense band of density ~ 35 HU seen in the intrahepatic fissure posteriorly (ligamentum venosum).No definite suspicious focal lesions or dilated intrahepatic biliary radicles seen.
Unremarkable CT features of gallbladder, CBD, portal vein, pancreas, spleen, adrenals, kidneys and urinary bladder.
This young patient, presenting with long-standing change of bowel habits, came to casualty with abdominal pain. There was suspicion of intestinal obstruction by abdominal radiograph, and this was followed with a CT examination showing the colon mass and bowel obstruction.
Subsequent colonoscopy and biopsy revealed adenocarcinoma of the colon, and he then underwent right hemicolectomy and adjuvant chemotherapy.
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