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CT Scan in Abdominal Emergency Surgery pp 123–136Cite as

The Role of Computed Tomography in the Acute Presentation of Colorectal Cancer

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Part of the book series: Hot Topics in Acute Care Surgery and Trauma ((HTACST))

Abstract

Patients affected by Colorectal cancer (CRC) can present acutely in a setting of occlusion, perforation, and lower gastrointestinal hemorrhage, which can all be life-threatening conditions. Traditional radiology is not sufficient for a complete clinical assessment. Computer Tomography (CT) is the most accurate diagnostic tool to evaluate the TNM staging, tumor side and potential complications. In stable patients without suspected perforation and with caution in occlusion, also Contrast Tomography Colo(CTC) can be useful.

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References

  1. American Cancer Society. Cancer facts & figures 2016. Atlanta: American Cancer Society; 2016.

    Google Scholar 

  2. Aakif M, Balfe P, Elfaedy O, Awan FN, Pretorius F, Silvio L, Castinera C, Mustafa H. Study on colorectal cancer presentation, treatment and follow-up. Int J Color Dis. 2016;31:1361–3.

    Article  Google Scholar 

  3. Cuffy M, Abir F, Audisio RA, Longo WE. Colorectal cancer presenting as surgical emergencies. Surg Oncol. 2004;13:149–57.

    Article  PubMed  Google Scholar 

  4. Romano S, Lombardo P, Cinque T, Tortora G, Romano L. Acute colonic disease: how to image in emergency. Eur J Radiol. 2007;61:424–32.

    Article  PubMed  Google Scholar 

  5. Zissin R, Hertz M, Osadchy A, Even-Sapir E, Gayer G. Abdominal CT findings in nontraumatic colorectal perforation. Eur J Radiol. 2008;65:125–32.

    Article  PubMed  Google Scholar 

  6. Gainant A. Emergency management of acute colonic cancer obstruction. J Visc Surg. 2012;149:e3–e10.

    Article  PubMed  CAS  Google Scholar 

  7. Sinha R, Verma R. Multidetector row computed tomography in bowel obstruction. Part 2. Large bowel obstruction. Clin Radiol. 2005;60:1068–75.

    Article  CAS  PubMed  Google Scholar 

  8. Matrawy KA, El-Shazly M. Intestinal obstruction: role of multi-slice CT in emergency department. Alexandria J Med. 2014;50:171–8.

    Article  Google Scholar 

  9. Priola AM, Priola SM, Volpicelli G, Giraudo MT, Martino V, Fava C, Veltri A. Accuracy of 64-row multidetector CT in the diagnosis of surgically treated acute abdomen. Clin Imaging. 2013;37:902–7.

    Article  PubMed  Google Scholar 

  10. Bhatt A, Goere D. Cytoreductive surgery plus HIPEC for peritoneal metastases from colrectal cancer. Indian J Surg Oncol. 2016;7(2):177–87.

    Article  PubMed  PubMed Central  Google Scholar 

  11. Hainaux B, Agneessens E, Bertinotti R, De Maertelaer V, Rubesova E, Capelluto E, Moschopoulos C. Accuracy of MDCT in predicting site of gastrointestinal tract perforation. AJR Am J Roentgenol. 2006;187:1179–83.

    Article  PubMed  Google Scholar 

  12. Ghekiere O, Lesnik A, Millet I, Hoa D, Guillon F, Taourel P. Direct visualization of perforation sites in patients with a non-traumatic free pneumoperitoneum: added diagnostic value of thin transverse slices and coronal and sagittal reformations for multi-detector CT. Eur Radiol. 2007;17:2302–9.

    Article  PubMed  Google Scholar 

  13. Taourel P, Garibaldi F, Arrigoni J, Le Guen V, Lesnik A, Bruel JM. Cecal pneumatosis in patients with obstructive colon cancer: correlation of CT findings with bowel viability. AJR Am J Roentgenol. 2004;183:1667–71.

    Article  PubMed  Google Scholar 

  14. Miki T, Ogata S, Uto M, Nakazono T, Urata M, Ishibe R, Shinyama S, Nakajo M. Multidetector-row CT findings of colonic perforation: direct visualization of ruptured colonic wall. Abdom Imaging. 2004;29:658–62.

    Article  PubMed  CAS  Google Scholar 

  15. Cho HS, Yoon SE, Park SH, Kim H, Lee YH, Yoon KH. Distinction between upper and lower gastrointestinal perforation: usefulness of the periportal free air sign on computed tomography. Eur J Radiol. 2009;69(1):108–13.

    Article  PubMed  Google Scholar 

  16. Yeung K-W, Chang M-S, Hsiao C-P, Huang J-F. CT evaluation of gastrointestinal tract perforation. Clin Imaging. 2004;28:329–33.

    Article  PubMed  Google Scholar 

  17. Sabharwal R, Vladica P, Chou R, Law WP. Helical CT in the diagnosis of acute lower gastrointestinal haemorrhage. Eur J Radiol. 2006;58:273–9.

    Article  PubMed  Google Scholar 

  18. Spada C, Stoker J, Alarcon O, Barbaro F, Bellini D, Bretthauer M, De Haan MC, Dumonceau J-M, Ferlitsch M, Halligan S, Helbren E, Hellstrom M, et al. Clinical indications for computed tomographic colonography: European Society of Gastrointestinal Endoscopy (ESGE) and European Society of Gastrointestinal and Abdominal Radiology (ESGAR) guideline. Eur Radiol. 2015;25:331–45.

    Article  PubMed  Google Scholar 

  19. Hong N, Park SH. CT colonography in the diagnosis and management of colorectal cancer: emphasis on pre- and post-surgical evaluation. World J Gastroenterol. 2014;20:2014–22.

    Article  PubMed  PubMed Central  Google Scholar 

  20. Mulder SA, Kranse R, Damhuis RA, de WJHW, Ouwendijk RJT, Kuipers EJ, van LME. Prevalence and prognosis of synchronous colorectal cancer: a Dutch population-based study. Cancer Epidemiol. 2011;35:442–7.

    Article  PubMed  Google Scholar 

  21. Adloff M, Arnaud JP, Bergamaschi R, Schloegel M. Synchronous carcinoma of the colon and rectum: prognostic and therapeutic implications. Am J Surg. 1989;157:299–302.

    Article  PubMed  CAS  Google Scholar 

  22. Pickhardt PJ. Incidence of colonic perforation at CT colonography: review of existing data and implications for screening of asymptomatic adults. Radiology. 2006;239:313–6.

    Article  PubMed  Google Scholar 

  23. Burling D, Halligan S, Slater A, Noakes MJ, Taylor SA. Potentially serious adverse events at CT Colonography in symptomatic patients: National Survey of the United Kingdom. Radiology. 2006;239:464–71.

    Article  PubMed  Google Scholar 

  24. Sosna J, Blachar A, Amitai M, Barmeir E, Peled N, Goldberg SN, Bar-Ziv J. Colonic perforation at CT colonography: assessment of risk in a multicenter large cohort. Radiology. 2006;239:457–63.

    Article  PubMed  Google Scholar 

  25. Atalla MA, Rozen WM, Niewiadomski OD, Croxford MA, Cheung W, Ho Y-H. Risk factors for colonic perforation after screening computed tomographic colonography: a multicentre analysis and review of the literature. J Med Screen. 2010;17:99–102.

    Article  PubMed  Google Scholar 

  26. Berrington de Gonzalez A, Kim KP, Yee J. CT colonography: perforation rates and potential radiation risks. Gastrointest Endosc Clin N Am. 2010;20:279–91.

    Article  PubMed  CAS  Google Scholar 

  27. Sali L, Falchini M, Taddei A, Mascalchi M. Role of preoperative CT colonography in patients with colorectal cancer. World J Gastroenterol. 2014;20:3795–803.

    Article  PubMed  PubMed Central  Google Scholar 

  28. Chung DJ, Chung DJ, Huh KC, Choi WJ, Kim JK. CT colonography using 16-MDCT in the evaluation of colorectal cancer. AJR Am J Roentgenol. 2005;184:98–103.

    Article  PubMed  Google Scholar 

  29. Utano K, Endo K, Togashi K, Sasaki J, Kawamura HJ, Horie H, Nakamura Y, Konishi F, Sugimoto H. Preoperative T staging of colorectal cancer by CT colonography. Dis Colon Rectum. 2008;51:875–81.

    Article  PubMed  Google Scholar 

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Author information

Authors and Affiliations

  1. Unit of General and Emergency Surgery, Papa Giovanni XXIII Hospital, P.zza OMS 1, Bergamo, 24128, Italy

    Laura Lomaglio & Giulia Montori

  2. Department of Radiology, Papa Giovanni XXIII Hospital, Milano-Bicocca University, Bergamo, Italy

    Anna Pecorelli & Sandro Sironi

  3. Department of Surgery, Macerata Hospital, Macerata, Italy

    Massimo Sartelli

  4. General, Emergency and Trauma Surgery Department, Bufalini Hospital, Cesena, Italy

    Luca Ansaloni & Federico Coccolini M.D.

Authors
  1. Laura Lomaglio
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  2. Giulia Montori
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  3. Anna Pecorelli
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  4. Sandro Sironi
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  5. Massimo Sartelli
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  6. Luca Ansaloni
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  7. Federico Coccolini M.D.
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Corresponding author

Correspondence to Federico Coccolini M.D. .

Editor information

Editors and Affiliations

  1. Emergency and Trauma Surgery, Ospedale Maggiore di Parma Emergency and Trauma Surgery, Parma, Parma, Italy

    Fausto Catena

  2. Cambridge Colorectal Unit, Cambridge University Hospitals NHS Foundation Trust, Addenbrooke’s Hospital, Cambridge, United Kingdom

    Salomone Di Saverio

  3. General, Emergency and Trauma Surgery, Department Bufalini Hospital, Cesena, Italy

    Luca Ansaloni

  4. General, Emergency and Trauma Surgery Department, Bufalini Hospital, Cesena, Italy

    Federico Coccolini

  5. Department of Surgery, Macerata Hospital, Macerata, Italy

    Massimo Sartelli

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Lomaglio, L. et al. (2018). The Role of Computed Tomography in the Acute Presentation of Colorectal Cancer. In: Catena, F., Di Saverio, S., Ansaloni, L., Coccolini, F., Sartelli, M. (eds) CT Scan in Abdominal Emergency Surgery. Hot Topics in Acute Care Surgery and Trauma. Springer, Cham. https://doi.org/10.1007/978-3-319-48347-4_12

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  • DOI: https://doi.org/10.1007/978-3-319-48347-4_12

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-48346-7

  • Online ISBN: 978-3-319-48347-4

  • eBook Packages: MedicineMedicine (R0)

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