Gastrointestinal oncologic emergencies: a radiologists' guide

The prevalence of cancer continues to increase both in the United States and worldwide. Oncologic emergencies are potentially life-threatening conditions in cancer patients, and these may be directly or indirectly related to the underlying malignancy. Radiologists must be well-versed not only in cancer staging, but also in potential cancer related complications and emergencies to guide prompt appropriate management. Oncologic emergencies may occur due to direct local effects by the tumor or metastasis, associated systemic manifestations, or due to treatment related effects. These emergencies may sometimes be the first presentation of the underlying malignancy. The various gastrointestinal oncologic emergencies include airway-esophageal fistula, intestinal obstruction, intestinal ischemia, intestinal perforation, intussusception, inflammatory/infectious bowel changes, torsion, and tumor-related gastrointestinal bleeding. This review article aims to highlight the clinical and key imaging manifestations of oncologic emergencies along with implications for management, with a particular focus on the gastrointestinal system.