Presentation
Abdominal pain and distention.
Patient Data
Abdominal x-ray demonstrates a distended colon with an apparent transition point in the left iliac fossa.
There is a 50mm, partially obstructing, circumferentially thickened, segment of large bowel at the level of the distal sigmoid colon. There is a surrounding mesenteric fat stranding with a 12mm left paraaortic node identified.
There are multiple nonenhancing low densities throughout the liver ranging in size from 8 mm to 24 mm. The gallbladder is absent. The CBD measures 7 mm.
Multiple high density foci in the the prostate represent either benign prostatic calcification or less likely brachytherapy seeds.
The a large pelvic calcification which lies immediately medial to the left vesicoureteric junction and may reside in a ureterocoele or bladder diverticulum. The left ureter is not dilated. A nonobstructing inferior pole renal calculus measuring 9 mm is identified. The kidneys, pancreas and spleen are otherwise unremarkable.
No free intra-abdominal fluid. No focal lung nodules visualized in the lower chest.
Extensive degenerative change throughout the lumbar spine and pelvis. Incidental small right hiatal hernia.
Case Discussion
Typical appearances of a stenosing colorectal carcinoma.