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• W1960455312 abstract "Computed tomography (CT) has become widely used as a screening test for patients with unexplained abdominal pain or weight loss. Clearly, the test has high sensitivity for primary and secondary hepatic neoplasms and for neoplasms of the pancreas and kidneys. However, sensitivity and specificity for the detection of neoplasms in the stomach and colon is much less clear. For example, at least some carcinomas are undetected while the diagnosis of cancer is confirmed in only a minority of patients with the CT findings of thickening of the wall of the stomach or colon. On CT, the left colon is marginally thicker than the right colon but normal values in adults range from 3 to 6 mm. The major features of cancer are asymmetrical or symmetrical thickening of the colonic wall, often with a narrow and irregular bowel lumen. Features of local spread outside the bowel wall include an irregular external border, strands of soft tissue extending from the serosal surface and loss of tissue fat planes between the colon and surrounding muscles. Thickening of the colonic wall can also occur in a variety of non-malignant disorders including diverticulosis, diverticulitis, inflammatory bowel disease, ischemic colitis and infectious colitis. Under most circumstances, patients with thickening of the gastric or colonic wall on CT will need to proceed to either upper gastrointestinal endoscopy or colonoscopy to exclude the diagnosis of cancer. In the patient illustrated below, a CT scan in a child resulted in the diagnosis of cancer at the rectosigmoid junction. The patient, an 8-year-old child, was admitted to hospital because of abdominal pain, change in bowel habit, weight loss and anemia. A CT scan was performed and axial images showed circumferential thickening of the wall of the rectosigmoid junction (arrows) with narrowing of the lumen over a distance of approximately 5 cm (Figure 1). The stricture was also shown on sagittal images (Figure 2). A biopsy confirmed the presence of adenocarcinoma. Colorectal cancer is extremely rare in children and young adults less than 20 years with a reported incidence of 1.3 cases per 1 million people. Although the majority of these cancers are ‘sporadic’, some of these children have hereditary non-polyposis colorectal cancer, familial adenomatous polyposis, inflammatory bowel disease or other rare cancer syndromes. In the above patient, there was no family history of colorectal or other cancers." @default.
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• W1960455312 date "2009-06-01" @default.
• W1960455312 modified "2023-10-12" @default.
• W1960455312 title "Gastrointestinal: Computed tomography scans and detection of colorectal cancer" @default.
• W1960455312 doi "https://doi.org/10.1111/j.1440-1746.2009.05880.x" @default.
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