Purpose. This study aimed to correlate multidetector-row computed tomography (MDCT) findings and postoperative prognosis in malignant large-bowel obstructions. Materials and methods. Twenty-seven patients affected by malignant colonic obstruction underwent MDCT examination and were analysed for obstruction site, colon-wall morphology, intestinal content alterations and transverse diameter of ascending colon. Results. Obstruction site was recognised in all cases (5/27 ascending colon; 1/27 transverse colon; 11/27 descending colon; 10/27 sigma-rectum). Intestinal content consisted of mainly air in 3/27 patients, mainly fluid in 11/27 and airfluid levels in 13/27. In 9/27 cases, pneumatosis intestinalis was found. Mean maximum diameter of the ascending colon was 8.2 cm. Overall mortality rate was 37%. An intestinal content mainly consisting of air (3/3 living patients) or fluid (7/11 living patients) were indicative of good prognosis. Air-fluid level detection indicated poor prognosis in 7/13 cases. Pneumatosis intestinalis (7/9 deceased patients) and ascending colon diameter values ≥10 cm (7/7 deceased patients) were indicative of poor prognosis. Conclusions. MDCT can identify the presence and site of malignant large-bowel obstructions and may provide useful prognostic information.
Prognostic value of MDCT in malignant large-bowel obstructions
ANGELELLI, Giuseppe;MOSCHETTA, MARCO;STABILE IANORA, Amato Antonio
2010-01-01
Abstract
Purpose. This study aimed to correlate multidetector-row computed tomography (MDCT) findings and postoperative prognosis in malignant large-bowel obstructions. Materials and methods. Twenty-seven patients affected by malignant colonic obstruction underwent MDCT examination and were analysed for obstruction site, colon-wall morphology, intestinal content alterations and transverse diameter of ascending colon. Results. Obstruction site was recognised in all cases (5/27 ascending colon; 1/27 transverse colon; 11/27 descending colon; 10/27 sigma-rectum). Intestinal content consisted of mainly air in 3/27 patients, mainly fluid in 11/27 and airfluid levels in 13/27. In 9/27 cases, pneumatosis intestinalis was found. Mean maximum diameter of the ascending colon was 8.2 cm. Overall mortality rate was 37%. An intestinal content mainly consisting of air (3/3 living patients) or fluid (7/11 living patients) were indicative of good prognosis. Air-fluid level detection indicated poor prognosis in 7/13 cases. Pneumatosis intestinalis (7/9 deceased patients) and ascending colon diameter values ≥10 cm (7/7 deceased patients) were indicative of poor prognosis. Conclusions. MDCT can identify the presence and site of malignant large-bowel obstructions and may provide useful prognostic information.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
