Multidetector CT of the Postoperative Colon: Review of Normal Appearances and Common Complications

Abstract

If not properly recognized, the normal postoperative appearance of the pelvis following colorectal surgery can be misinterpreted as disease, including infection or recurrent tumor. However, multidetector computed tomography (CT) with the supplemental use of multiplanar reformation clearly demonstrates the expected postoperative anatomic changes in this setting. The high-resolution images achievable with multidetector CT enable the radiologist to play an important role in the postoperative assessment of patients following colon surgery. Whenever possible, the radiologist should be aware of the specific indication for the study, the type of surgery that was performed (ranging from segmental bowel excision to more extensive radical resection), and what anastomoses were created. This knowledge, as well as familiarity with the normal multidetector CT appearances of various postoperative complications, is critical for prompt diagnosis and appropriate management of these complications and for better differentiation of complications from normal findings.

Advanced rectal cancer in a long-term Hartmann's pouch: a forgotten organ revisited

“…Despite the misconception of the pouch as a blind-ended rectum, Hartmann's pouch can extend proximally as far as the transverse colon; this defunctionalised distal pouch has a high potential for pathological lesions 3 4…”

“…This is usually performed through radiological investigations or direct endoscopic visualisation 3 4…”

Extended Low Anterior Resection with a Circular Stapler in Patients with Rectal Cancer: a Single Center Experience

“…The mainstay for the treatment of rectal cancer is surgery. The choice of surgical technique is influenced by the severity of disease and the extent of disease spread in the bowel, the location of the tumor, the stage of the cancer, the patient's preference, and experience of the surgeon (Osei-Bonsu et al, 2013). Current surgical procedures for rectal cancers include abdomino perineal resection (APR), low anterior resection and extended low anterior resection.…”

Post-operative rectal carcinoma: Follow-up imaging findings up to 6 years

“…1 (2,9) 1 (2,9) 0 1 (2,9) 2 (5,9) 1 (2,9) 3 (8,8) 1 (2,9) 2 (5,9) 1 (2,9) 14 (66,6) 11 (52,3) 3 ( Tartışma RK olgularında operasyon sonrası değişikliklerin saptanmasında BT, MRG ve PET-BT gibi görüntüleme tetkikleri oldukça başarılıdır. Ancak özellikle operasyon sonrası presakral bölgede görülen lezyonların tümör rekürrensi ve operasyon sonrası granülasyon-fibrotik değişiklik açısından ayrımının yapılması zaman zaman zor olmaktadır.…”

“…Ancak özellikle operasyon sonrası presakral bölgede görülen lezyonların tümör rekürrensi ve operasyon sonrası granülasyon-fibrotik değişiklik açısından ayrımının yapılması zaman zaman zor olmaktadır. Bu ayrımda takip görüntülemelerin faydalı olduğu bildirilmiştir (2,3,5). Ameliyat sonrası yapılan görüntüleme tetkiki değerlendirilirken radyologların mümkünse çekim endikasyonunu ve uygulanan cerrahi tipini bilmesi oldukça önemlidir.…”