Sigmoid carcinoma with foreign body perforation

Case contributed by Wayland Wang
Diagnosis almost certain

Presentation

Acute abdominal pain after eating a roast chicken.

Patient Data

Age: 70 years
Gender: Male
This study is a stack
Axial C+ portal
venous phase
This study is a stack
Coronal C+ portal
venous phase
This study is a stack
C+ portal
venous phase
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Info

Peritoneal free gas is present in keeping with perforation. The sigmoid demonstrates surrounding fat stranding. A tubular osseous density structure is present in the sigmoid colon, suspicious for ingested foreign body.

Just distal to the foreign body there is a stenosing luminal mass, with stranding in the sigmoid mesocolon and tubular soft tissue extension beyond the colonic serosa.

Conclusion:

Sigmoid carcinoma with associated perforation, which is likely related to impaction of an ingested foreign body (fragment of animal bone).

Case Discussion

This is an unusual presentation of a sigmoid cancer, with an impacted foreign body (fragment of animal bone) resulting in perforation.

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