Presentation
Chronic constipation
Patient Data
On double contrast barium study; dolichocolon is evident. There is short segment stricture with shouldering appearance and apple core sign at proximal of transverse colon suggestive for tumoral infiltration.
Increased wall thickness due to tumoral infiltration is present at proximal of transverse colon measuring about 8 cm in length and accompanied by a few small regional lymphadenopathies.
Case Discussion
Further colonoscopy evaluation in this patient shows an infiltrative mass at proximal portion of the transverse colon and tissue exam confirms colon adenocarcinoma.
Colorectal cancers can be found anywhere from the cecum to the rectum and transverse colon involvement includes about 10% of cases.1
The apple core sign in barium study of colon is most frequently associated with constriction of the lumen of the colon by a stenosing annular colorectal carcinoma.2
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