Cecal Pneumatosis in Patients with Obstructive Colon Cancer: Correlation of CT Findings with Bowel Viability

Abstract

CT findings of cecal pneumatosis do not always indicate transmural infarction in patients with acute large-bowel obstruction due to colon cancer. Cecal pneumatosis may be related to viable bowel when it displays a bubblelike pattern or when it is not associated with other findings of ischemia.

CT Findings of Sigmoid Volvulus

“…However, CT findings were present in all three patients with bowel necrosis, suggesting higher sensitivity if frank infarction is present. Results of some previous studies suggest that the CT findings of ischemia are insensitive [14] and nonspecific [15,16], but others have shown high sensitivity in the detection of bowel wall compromise [17] and good correlation with extent of ischemia or infarction [18,19].…”

Pneumatosis Intestinalis Caused by Ischaemic Bowel: Report of Three Cases

“…Portal venous gas is to be considered an omentous sign. In cases of ischaemic bowel, the display of a bubble-like pattern (as opposed to the linear presentation) may be related to viable bowel (4).…”

Bowel Perforations

“…In contrast, in cecal diastatic perforations, with accompanying CT signs of large bowel obstruction and a distended colon, the pneumoperitoneum is often highly abundant. A cecal parietal pneumatosis is sometimes associated with such an abundant pneumoperitoneum, pointing toward the site and mechanism of perforation, although not specific to cecal transmural distress in the setting of colic mechanical obstruction (Taourel et al 2004).…”