Routine preoperative abdominal computed tomography in colon cancer: a utility study.

BACKGROUND: There is no proven utility for preoperative scanning of intraperitoneal colonic cancer with computed tomography (CT). A prospective study was conducted where CT was preoperatively incorporated into the management algorithm to ascertain its role in patient treatment. METHODS: Thoraco-abdominal CT was performed in both the elective and emergency settings in an unselected group of 73 patients referred to a coloproctology unit established over the last 30 months at the Queen Elizabeth Hospital, Barbados. CT and operative findings were compared to determine the influence that the preoperative CT had on surgical decision making. RESULTS: Unexpected additional pathology was found in 6.8% of patients. Sensitivity for the detection of visceral metastatic disease was 84.6%. Preoperative CT was deemed to be of clinical value in 24.7% of cases and to definitively alter surgical management in 13.7% of patients. These alterations in management included several types of multivisceral resections, the need for ureteric stenting or reimplantation, the utilization of stomas alone and the avoidance of resection in known metastatic disease. CONCLUSIONS: Preoperative CT of intraperitoneal colonic cancer adds important technical information to the conduct of the surgery and alters therapy in a selected patient group.

[Radioimmunoscintigraphy of colorectal cancer using the anti-CEA monoclonal antibody BW 431/26. Final results]. / Radioinmunocentellografía del cáncer colorrectal empleando el anticuerpo monoclonal BW 431/26 anti-CEA. Resultados finales.

The anti-carcinoembryonic antigen (CEA) antibody, BW 431/26 (Scintimun CEA, Behringwerke, Marburg, Germany ) labeled with technetium pertechnectate (99mTc), is an intact immunoglobulin G1, monoclonal antibody that has been used to image colorectal cancer. Planar and SPECT images of chest, abdomen and pelvis were performed at 10 minutes, 4-6 and 18-24 hours after the intravenous antibody injection. 44 patients were studied and the pathological antibody concentration localization by radioimmunoimaging (RI) were correlated with surgical, clinical and other imaging modality findings to validate the RI. The RI was positive in 29 patients and negative in the other 15 patients. The CEA and CA 19.9 were elevated in the serum of some patients with primary tumors or recurrence. The HAMA were determined in all the patients before and after the RI.

Rectosigmoid lipoma an unusual colonic lipoma. Case report and review of the literature.

This is a case report of a male patient admitted with a huge rectosigmoid mass that had eroded into the lumen, causing persistent rectal bleeding. Special procedures such as double contrast Barium Enema, abdomino-pelvic CT-Scan and proctosigmoidoscopy addressed us to identify it as an intramural lipoma. Rectosigmoid lipoma with its differential diagnosis and surgical approach is reviewed together with the most pertinent literature.

Doble contraste colónico: valor diagnóstico en la patología polipoidea y tumoral / Double colonic contrast: diagnostic value of the polypoid and tumoral pathology

Se presenta la experiencia en el estudio de 563 pacientes con exámenes del colon con técnica de doble contraste. En 262 casos (47%) el resultado fue patológico: alteraciones congénitas (5.3%), divertículos (72%), alteraciones inflamatorias (4.0%) y tumores (18.3%). Se describe la técnica que se emplea y se analiza la semiología que permite los diferentes diagnósticos. Se remarcan los diagnósticos diferenciales y errores diagnósticos más frecuentemente observados. Se concluye que solamente con técnica de doble contraste son posibles diagnósticos de lesiones menores de 1cm. Con la técnica de doble contraste se logra una mayor complementación con la endoscopia para un mejor diagnóstico final