Perforated, malignant large bowel obstruction due to caecal distension and venous ischaemia

Case contributed by Dr Chris O'Donnell

Presentation

Abdominal pain and distension. Nil passage of flatus, ? bowel obstruction

Patient Data

Age: 90
Gender: Male

Patient unwell so no IV or oral contrast

Modality: CT

Distension of the colon to the sigmoid with abrupt transition to collapsed rectum. Irregular mass in the sigmoid is probably cancer although a diverticular stricture is possible. Gross caecal dilatation with swollen irregular, gas-filled mucosa is compatible with ischaemia (probably venous due to luminal distension) and free gas indicating perforation, although the site of perforation is not identified.

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Case Information

rID: 30262
Case created: 30th Jul 2014
Last edited: 20th Nov 2015
Tag: colon
Inclusion in quiz mode: Included

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