Computed Tomographic Findings of Malignant Bowel Neoplasms: A Retrospective Study

Abstract

Introduction: Malignant neoplasms of bowel particularly colorectal carcinomas are third commonest cause of death all over world. Computed Tomography (CT) plays a very important role in evaluation of malignant bowel neoplasms. CT examination for gastrointestinal tract evaluates the intestinal lumen along with demonstration of intestinal wall, adjacent tissues and solid viscera. Aim: To evaluate malignant neoplasms of small and large intestine and also to define the various CT findings in malignant bowel neoplasms, extra-intestinal involvement to stage intestinal neoplasms and to accurately characterise the tumour histologically as far as possible. Materials and Methods: A retrospective descriptive study included 38 patients who were proven to have malignancy of bowel on biopsy, underwent CT abdomen in major public hospital in a period of from November 2014 to May 2017 and evaluated for various CT findings in malignant bowel neoplasms in terms of involved intestine, length of diseased intestinal segment, degree of intestinal wall thickening, extra-intestinal involvement to stage bowel neoplasms and to accurately characterise the tumour histologically as far as possible. Data were tabulated and presented as frequency (n) and precentage (%). Results: In Small intestine, ileum is the commonest site of involvement seen in 5 cases (13%), whereas rectum 10 cases (26.3%) was the commonest site of involvement in large intestine. Short segment involvement of bowel is more common 27 cases (71.1%) than long segment involvement 11 cases (28.9%). Circumferential wall thickening is more common in 33 cases (86.8%) than eccentric wall thickening 5 cases (13.2%). Lymph nodal involvement was seen in 17 cases (44%) and metastasis to liver was also seen in 11 cases (28.9%). Local invasion with involvement of surrounding structures was seen in 4 cases (10.5%). Adenocarcinoma was the commonest histological subtype seen in the highest number of cases 23 cases (60.5%), followed by lymphoma in 9 (23.6%) of cases, mucinous adenocarcinoma in 4 (10.5%) cases and few cases of about 2 (5.2%) were Gastrointestinal Stromal Tumour (GIST). Conclusion: Computed Tomography (CT) imaging findings like involved intestine, length of diseased intestinal segment, degree of intestinal wall thickening, extra intestinal involvement with respect to involvement of surrounding structures, lymph nodal involvement, distant metastasis along with histological type in most cases could be found, thus permitting tumour characterisation which can provide very useful guide in diagnosis of malignant neoplasms of small and large intestine.

Keywords

• computed tomography
• large intestine
• metastasis
• small intestine
• wall thickening