Prognostic value of MDCT in malignant large-bowel obstructions.
OBJECTIVE
This study aimed to correlate multidetector-row computed tomography (MDCT) findings and postoperative prognosis in malignant large-bowel obstructions.


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 air-fluid 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 > or =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.
Angelelli
G
G
Di.M.I.M.P. - Sezione di Diagnostica per Immagini, Policlinico Universitario, Piazza Giulio Cesare 11, 70124 Bari, Italy. g.angelelli@radiologia.uniba.it
Moschetta
M
M
Binetti
F
F
Cosmo
T
T
Stabile Ianora
A A
AA
D000368:Aged; D000369:Aged, 80 and over; D003110:Colonic Neoplasms / Q000150:complications* / Q000000981:diagnostic imaging* / Q000401:mortality; D005260:Female; D006801:Humans; D007415:Intestinal Obstruction / Q000000981:diagnostic imaging* / Q000209:etiology* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011857:Radiographic Image Interpretation, Computer-Assisted; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed / Q000379:methods*