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Colonic Metastases and Lymphoma

KEY FACTS Imaging Multiplanar, contrast-enhanced CT (or PET/CT) is optimal imaging test Protocol advice Intravenous contrast for CT or MR Double contrast barium enema Lymphoma Bulky colonic mass; without colonic obstruction Preservation of fat planes Metastasis May mimic primary adenocarcinoma on imaging You’re Reading a Preview Become a Clinical Tree membership for Full access and enjoy Unlimited articles Become membership If you are a member. Log…

Familial Polyposis and Gardner Syndrome

KEY FACTS Terminology Autosomal dominant genetic disorder characterized by formation of innumerable colonic adenomatous polyps at young age and increased risk for colonic and extracolonic tumors Imaging Imaging tests : Double-contrast barium studies of colon and upper GI tract (may be redundant with endoscopy) CT or MR (for abdominal tumors) Innumerable colonic filling defects or ring shadows ± extraintestinal lesions Adenomatous (± malignant) polyps in Colon…

Colon Carcinoma

KEY FACTS Imaging Imaging is critical for detection, diagnosis, staging, and follow-up of colorectal carcinoma (CRC) Detection : CT colonography, plus stool analysis Complementary role with standard colonoscopy Early cancer: Sessile or pedunculated polyp Advanced cancer: "Saddle" or "apple core" lesion – Circumferential narrowing of bowel lumen, overhanging borders, mucosal destruction Staging : Helical CT ± MR Short segment (< 10 cm) asymmetric mural thickening & luminal narrowing…

Colorectal Trauma

KEY FACTS Terminology Blunt or penetrating injury to rectum or colon Imaging Transverse and descending colon are most common sites for blunt traumatic injury Rectum is most common site for penetrating injury Best diagnostic clue Colonic wall thickening with adjacent mesenteric hemorrhage or ectopic gas Best imaging tool: CECT with multiplanar reformations Rectal and intravenous contrast for penetrating injuries CT signs Discontinuity or thickening of colonic…

Enteric Fistulas and Sinus Tracts

KEY FACTS Terminology Enteric fistula : Abnormal connection between bowel and another epithelial-lined surface (e.g., bladder, vagina, skin) Enteric sinus tract : Blind-ending tract originating from bowel Imaging Fluoroscopy Fistulogram: Best modality for enterocutaneous fistulas Small bowel follow-through : Complementary to CT or MR enterography for Crohn's disease Contrast enema : Often definitive for colonic fistulas (to bladder, vagina, etc.) CT: Primary or complementary role Definitive…

Colonic Ileus and Ogilvie Syndrome

KEY FACTS Terminology Ogilvie syndrome, colonic pseudoobstruction, adynamic ileus, functional obstruction Acute: Reversible, occurring with severe medical illness and major surgeries Chronic: Constipation, no etiology for ileus, and repeated obstructive symptoms You’re Reading a Preview Become a Clinical Tree membership for Full access and enjoy Unlimited articles Become membership If you are a member. Log in here

Cecal Volvulus

KEY FACTS Terminology Cecal volvulus : Rotational twist of right colon on its axis, resulting in progressive distention and potential ischemia Cecal bascule Cecum is distended and lumen narrowed by medial folding and displacement, without twist You’re Reading a Preview Become a Clinical Tree membership for Full access and enjoy Unlimited articles Become membership If you are a member. Log in here

Sigmoid Volvulus

KEY FACTS Terminology Torsion or twisting of sigmoid colon around its mesenteric axis, resulting in progressive dilation & possible perforation You’re Reading a Preview Become a Clinical Tree membership for Full access and enjoy Unlimited articles Become membership If you are a member. Log in here

Epiploic Appendagitis

KEY FACTS Terminology Acute inflammation or infarction of epiploic appendages (EA, fat-filled serosal outpouchings on colonic surface) You’re Reading a Preview Become a Clinical Tree membership for Full access and enjoy Unlimited articles Become membership If you are a member. Log in here

Neutropenic Enterocolitis (Typhlitis)

KEY FACTS Terminology Life-threatening, necrotizing enterocolitis occurring primarily in severely neutropenic patients Imaging Best imaging tool: CECT with multiplanar reformations Massive mural thickening of cecal ± ascending colon wall – Other segments of colon and small bowel can be affected Mucosal hyperenhancement and submucosal edema (marked) Infiltration of pericolonic fat Less common, more severe findings Pneumatosis, extraluminal gas and fluid (perforation) Top Differential Diagnoses Pseudomembranous colitis…