Abstract
The increased utilization of neoadjuvant strategies in cancer has been significantly enhanced by accurate novel preoperative imaging techniques. These studies provide more exact staging with consequently improved patient selection, increased use of multimodal therapies, and a higher likelihood of sphincter preservation, R0 resections, successful repeat resections, and multivisceral extirpation. Routine use of computed tomography (CT) scanning has better defined postoperative septic complications and has changed the surgical paradigm in the management of complicated diverticular disease. This chapter outlines the principles involved in the use of radiology for the postoperative colorectal patient, including plain radiology, CT scanning, radionuclide imaging, and fusion positron emission tomography scanning.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Thoeni RF, Thornton R. Radiology of the colon. In: Wexner SD, Stollman N, editors. Diseases of the colon. New York: Informa Healthcare; 2007. p. 163–210.
Miller RE, Becker GJ, Slabaugh RA. Detection of pneumoperitoneum: optimum body position and respiratory phase. AJR Am J Roentgenol. 1980;135:487–90.
Levine MS, Scheiner JD, Rubesin SE, Laufer I, Herlinger H. Diagnosis of pneumoperitoneum on supine abdominal radiographs. AJR Am J Roentgenol. 1991;156:731–5.
Miller RE. The radiological evaluation of intraperitoneal gas (pneumoperitoneum). CRC Crit Rev Clin Radiol Nucl Med. 1973;4:61–85.
Tang CL, Yeong KY, Nyam DC, Eu KW, Ho YH, Leong AF, et al. Postoperative intra-abdominal free gas after open colorectal resection. Dis Colon Rectum. 2000;43:1116–20.
Harlow CL, Stears RL, Zeligman BE, Archer PG. Diagnosis of bowel obstruction on plain abdominal radiographs: significance of air-fluid levels at different heights in the same loop of bowel. AJR Am J Roentgenol. 1993;161:291–5.
Mutch MG, Birnbaum EH, Menias CO. Diagnostic evaluations – radiology, nuclear scans, PET, CT-colography. In: Wolff BC, Fleshman JW, Beck DE, Pemberton JH, Wexner SD, editors. The ASCRS textbook of colon and rectal surgery. New York: Springer; 2007. p. 69–100.
Low VH. Colonic pseudo-obstruction: value of prone lateral view of the rectum. Abdom Imaging. 1995;20:531–3.
Ballantyne GH. Volvulus of the colon. In: Fazio VW, editor. Current therapy in colon and rectal surgery. Philadelphia: BC Decker; 1990. p. 254–65.
Bubrick MP. Volvulus of the colon. In: Gordon PH, Nivatvongs S, editors. Principles and practice of surgery for the colon, rectum and anus. St. Louis: Quality Medical Publishing Inc.; 1992. p. 799–816.
Pfeifer J, Hammer H. Volvulus. In: Wexner SD, Stollmann N, editors. Diseases of the colon. New York: Informa Healthcare; 2006. p. 463–75.
Kerry RL, Lee F, Ransom HK. Roentgenologic examination in the diagnosis and treatment of colonic volvulus. AJR Am J Roentgenol. 1971;113:343–8.
Karkhanis S, Medcalf J. Plain abdomen radiographs: the right view? Eur J Emerg Med. 2009;16:267–70.
Smith JE, Hall EJ. The use of plain abdominal x-rays in the emergency department. Emerg Med J. 2009;26:160–9.
Löw M, Jaschinski U. Intrahospital transport of critically ill patients. Anaesthesist. 2009;58:95–107.
Martin CJ, Hunter S. Reduction of patient doses from barium meal and barium enema examinations through changes in equipment factors. Br J Radiol. 1994;67:1196–205.
Bartram CI, Halligan S. Imaging. In: Nicholls JR, Dozois RR, editors. Surgery of the colon and rectum. New York: Churchill Livingstone; 1997. p. 85–113.
Morini S, Zullo A, Hassan C, Lorenzetti R, Campo SM. Endoscopic management of failed colonoscopy in clinical practice: to change endoscopist, instrument, or both? Int J Colorectal Dis. 2011;26: 103–8.
Branco BC, Barmparas G, Schnüriger B, Inaba K, Chan LS, Demetriades D. Systematic review and meta-analysis of the diagnostic and therapeutic role of water-soluble contrast agent in adhesive small bowel obstruction. Br J Surg. 2010;97:470–8.
Kalady MF, Mantyh CR, Petrofski J, Ludwig KA. Routine contrast imaging of low pelvic anastomosis prior to closure of defunctioning ileostomy: is it necessary? J Gastrointest Surg. 2008;12:1227–31.
Zbar AP, Armitage NC. Complex perirectal sepsis: clinical classification and imaging. Tech Coloproctol. 2006;10:83–93.
McIntyre PB, Ritchie JK, Hawley PR, Bartram CI, Lennard-Jones JE. Management of enterocutaneous fistulas: a review of 132 cases. Br J Surg. 1984;71:293–6.
Severini A, Civelli EM, Uslenghi E, Cozzi G, Salvetti M, Milella M, et al. Diagnostic and interventional radiology in the post-Âoperative period and follow-up of patients after rectal resection with coloanal anastomosis. Eur Radiol. 2000;10:1101–5.
Casadesus D, Villasana L, Sanchez IM, Diaz H, Chavez M, Diaz A. Treatment of rectovaginal fistula: a 5-year review. Aust N Z J Obstet Gynaecol. 2006;46:49–51.
Biewenga P, Mutsaerts MA, Stalpers LJ, Buist MR, Schilthuis MS, van der Velden J. Can we predict vesicovaginal or rectovaginal fistula formation in patients with stage IVA cervical cancer? Int J Gynecol Cancer. 2010;20:471–5.
Karsten BJ, King JB, Kumar RR. Role of water-soluble enema before takedown of diverting ileostomy for low pelvic anastomosis. Am Surg. 2009;75:941–4.
Ohmiya N, Arakawa D, Nakamura M, Honda W, Shirai O, Taguchi A, et al. Small-bowel obstruction: diagnostic comparison between double-balloon endoscopy and fluoroscopic enteroclysis, and the outcome of enteroscopic treatment. Gastrointest Endosc. 2009;69:84–93.
Jensen MD, Kjeldsen J, Nathan T, Rafaelsen SR. Diagnostic imaging and endoscopic methods in Crohn’s disease of the small intestine. Ugeskr Laeger. 2009;171:2383–8.
Rea JD, Lockhart ME, Yarbrough DE, Leeth RR, Bledsoe SE, Clements RH. Approach to management of intussusception in adults: a new paradigm in the computed tomography era. Am Surg. 2007;73:1098–105.
Guillén Paredes MP, Campillo Soto A, MartÃn Lorenzo JG, Torralba MartÃnez JA, Mengual Ballester M, Cases Baldó MJ, et al. Adult intussusception – 14 case reports and their outcomes. Rev Esp Enferm Dig. 2010;102:32–40.
Simper SC, Erzinger JM, McKinlay RD, Smith SC. Retrograde (reverse) jejunal intussusception might not be such a rare problem: a single group’s experience of 23 cases. Surg Obes Relat Dis. 2008;4:77–83.
Zbar AP, Murphy F, Krishna SM. Adult postoperative intussusceptions: a rare cause of small bowel obstruction. South Med J. 2007;100:1042–4.
Walker TG. Acute gastrointestinal hemorrhage. Tech Vasc Interv Radiol. 2009;12:80–91.
van Delden OM, Rauws EA, Gouma DJ, Laméris JS. Increasing role for angiographic embolisation in the treatment of gastrointestinal haemorrhage. Ned Tijdschr Geneeskd. 2006;150:956–61.
Katzberg RW, Newhouse JH. Intravenous contrast medium-induced nephrotoxicity: is the medical risk really as great as we have come to believe? Radiology. 2010;256:21–8.
Destigter KK, Keating DP. Imaging update: acute colonic diverticulitis. Clin Colon Rectal Surg. 2009;22:147–55.
Hansen O, Stock W. Prophylaktische Operation bei Divertikelerkrankung des Kolons – Stufenkonzept durch exakte Stadieneinteilung. Langenbecks Arch Chir. 1999;(Suppl II);1257–60.
Dharmarajan S, Hunt SR, Birnbaum EH, Fleshman JW, Mutch MG. The efficacy of nonoperative management of acute complicated diverticulitis. Dis Colon Rectum. 2011;54:663–71.
Gore RM, Marn CS, Kirby DF, Vogelzang RL, Neiman HL. CT findings in ulcerative, granulomatous, and indeterminate colitis. AJR Am J Roentgenol. 1984;143:279–84.
Jensen MD, Ormstrup T, Vagn-Hansen C, Ostergaard L, Rafaelsen SR. Interobserver and intermodality agreement for detection of small bowel Crohn’s disease with MR enterography and CT enterography. Inflamm Bowel Dis. 2011;17:1081–8.
Wu YW, Tang YH, Hao NX, Tang CY, Miao F. Crohn’s disease: CT enterography manifestations before and after treatment. Eur J Radiol. 2012;81:52–9.
Hoeffel C, Marcus C, Arrivé L, Bouché O, Tubiana J. Postoperative imaging after colorectal surgery. J Radiol. 2009;90(7–8 Pt 2):954–68.
Balthazar EJ, Yen BC, Gordon RB. Ischemic colitis: CT evaluation of 54 cases. Radiology. 1999;211:381–8.
Kidmas AT, Ekedigwe JE, Sule AZ, Pam SD. A review of the radiological diagnosis of small bowel obstruction using various imaging modalities. Niger Postgrad Med J. 2005;12:33–6.
Inaba Y, Arai Y, Kanematsu M, Takeuchi Y, Matsueda K, Yasui K, et al. Revealing hepatic metastases from colorectal cancer: value of combined helical CT during arterial portography and CT hepatic arteriography with a unified CT and angiography system. AJR Am J Roentgenol. 2000;174:955–61.
Stevens WR, Johnson CD. Computed tomography and magnetic resonance imaging. In: Nicholls RJ, Dozois RR, editors. Surgery of the colon and rectum. New York: Churchill Livingstone; 1997. p. 114–34.
Danse E, Goncette L, Kartheuser A. Optimal diagnosis of anastomotic colorectal leak by combination of conventional colonic enema and CT. JBR-BTR. 2007;90:526–7.
Veerappan GR, Ally MR, Choi JH, Pak JS, Maydonovitch C, Wong RK. Extracolonic findings on CT colonography increases yield of colorectal cancer screening. AJR Am J Roentgenol. 2010;195:677–86.
Laghi A, Iafrate F, Rengo M, Hassan C. Colorectal cancer screening: the role of CT colonography. World J Gastroenterol. 2010;16:3987–94.
Faccioli N, Foti G, Barillari M, Zaccarella A, Camera L, Biasiutti C, et al. A simplified approach to virtual colonoscopy using different intestinal preparations: preliminary experience with regard to quality, accuracy and patient acceptability. Radiol Med. 2011;116:749–58.
Liedenbaum MH, Denters MJ, Zijta FM, van Ravesteijn VF, Bipat S, Vos FM, et al. Reducing the oral contrast dose in CT colonography: evaluation of faecal tagging quality and patient acceptance. Clin Radiol. 2011;66:30–7.
Keeling AN, Slattery MM, Leong S, McCarthy E, Susanto M, Lee MJ, et al. Limited-preparation CT colonography in frail elderly patients: a feasibility study. AJR Am J Roentgenol. 2010;194:1279–87.
Yang JG, Yin CH, Li CL, Zou LF. Meckel’s diverticulum and intestinal duplication detected by Tc-99m pertechnetate scintigraphy. Clin Nucl Med. 2010;35:275–6.
Chowdhury FU, Shah N, Scarsbrook AF, Bradley KM. [18F]FDG PET/CT imaging of colorectal cancer: a pictorial review. Postgrad Med J. 2010;86:174–82.
Mirnezami AH, Sagar PM, Kavanagh D, Witherspoon P, Lee P, Winter D. Clinical algorithms for the surgical management of locally recurrent rectal cancer. Dis Colon Rectum. 2010;53:1248–57.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2013 Springer-Verlag London
About this chapter
Cite this chapter
Pfeifer, J. (2013). The Role of Conventional Radiology. In: Zbar, A., Madoff, R., Wexner, S. (eds) Reconstructive Surgery of the Rectum, Anus and Perineum. Springer, London. https://doi.org/10.1007/978-1-84882-413-3_1
Download citation
DOI: https://doi.org/10.1007/978-1-84882-413-3_1
Published:
Publisher Name: Springer, London
Print ISBN: 978-1-84882-412-6
Online ISBN: 978-1-84882-413-3
eBook Packages: MedicineMedicine (R0)