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Case: Large Bowel Colonic Obstruction

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Alright, we're going to continue our journey

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through bowel obstructions.

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Here we have a contrast-enhanced CT scan of the

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abdomen and pelvis, noting that the liver looks

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normal and the spleen looks normal here as well.

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The kidneys look pretty good.

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No evidence of hydronephrosis, pancreas within normal

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limits, but as we come through the abdomen, we see

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extremely dilated colon with, uh, internal feces.

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All the way down to the pelvis where

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there's an abrupt caliber change into

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the rectum. Noting the caliber change,

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there isn't a large mass here.

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I don't see any significant lymphadenopathy.

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Um, obviously, we are always concerned about

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obstructing masses or obstructing colon cancers, and

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that is a cause for colonic obstruction for sure.

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In this case, I don't necessarily see that, but it

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would need to correlate that with history.

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On the coronal views, we really see how

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dramatic this colonic dilatation is.

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This colon is completely obstructed with a lot

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of liquid stool and significant dilatation of

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the entire colon down to the level of the rectum,

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where again, we see that abrupt caliber change

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consistent with a large bowel colonic obstruction.

Report

Faculty

Laura L Avery, MD

Assistant Professor of Emergency Radiology Harvard Medical School

Massachusetts General Hosptial

Tags

Small Bowel

Gastrointestinal (GI)

Emergency

CT

Body

Acquired/Developmental