Emergency and Trauma Imaging

Abdominal Emergencies in Cancer Patients

“…28 Multi-detector computed tomography (MDCT) has a high accuracy for the diagnosis of severe SBO (almost 95%) but it is less sensitive and specific in case of partial obstruction (with a variable range of 83-100% in sensitivity and 61-93% in specificity). 2,[24][25][26][27]29 Because of the multitude of differential diagnoses (ranging from bleeding hypervascular metastases to carcinomatosis), more recent publications have investigate the role of biphasic CT protocol in suspected small bowel obstruction at the emergency department. The positive predictive value of biphasic MDCT accounts for 92.9% for AMI, indicating the possibility to reduce patient radiation dose, numbers of images to review and unnecessary delays in patient work-up.…”

“…Postoperatively, up to 25% of patients with a colorectal cancer resection develop a LBO. 2,30 Similar to SBO, mechanical obstruction of the large bowel causes bowel dilatation above the site of obstruction but it usually takes longer time for patient to present with symptoms of obstruction. Therefore, it rarely is an emergency until in the latest stages (for example, a stenosing cancer causing caecal dilatation over 8 cm) (Figure 2).…”

“…This may represent a diagnostic challenge since they usually present with nonspecific symptoms resulting in diagnostic delay with development of carcinomatosis, advanced stage IV disease, direct invasion or lymphatic system and hematogenous metastases. 2…”

“…Intravenous contrast medium administration is essential for assessing intestinal loop enhancement and mesenteric vascular supply. 2,25,26…”

“…Multi-detector computed tomography (MDCT) has a high accuracy for the diagnosis of severe SBO (almost 95%) but it is less sensitive and specific in case of partial obstruction (with a variable range of 83-100% in sensitivity and 61-93% in specificity). 2,24 –27,29…”