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[Perforated carcinoma of the colorectum. Computerized tomography findings]
1Istituto di Scienze Radiologiche, Facoltà di Medicina e Chirurgìa, Università Federico II, Napoli.
Purpose:
To describe the possible CT features of perforated colorectal tumors and to discuss the practical value of detecting this complication.
Material And Methods:
The CT examinations of 16 patients with perforated large bowel neoplasms were retrospectively reviewed. The most frequent locations were the sigmoid colon (6 cases), the cecum and ascending colon (4 cases) and the descending colon (4 cases). A correlation with barium enema findings was possible in 12 patients while in 14 subjects surgical confirmation was obtained.
Results:
The colorectal neoplasm was depicted on CT scans in 94% of cases, as a mural thickening or a mass, and was usually in the advanced stage. Phlegmonous tissue was shown only in 19% of the cases, while an abscess was detected in 81%, more frequently appearing as a well-defined fluid-filled collection near the tumor. Large bowel enema was positive for perforated neoplasm only in 5 cases.
Conclusion:
CT demonstrates perforated colorectal tumors better than conventional methods, which is a relevant information for both surgery and prognosis. In the diagnostic phase CT is indicated when clinical and/or barium enema findings are atypical. In the staging phase, the detection of this complication represents a valuable information.