Image Based Question-71136

A 78-year-old woman complained of per rectal bleeding, signifi cant loss of weight and appetite for one month. Physical examination did not reveal any abdominal mass. No haemorrhoids were present

on proctoscopy. Blood tests showed a hypochromic microcytic anaemia .A contrast enema was performed.What can be the most possible diagnosis?

A. Large Bowel Obstruction

B. Colonic Carcinoma

C. Sigmoid Volvulus

D. Colonic Diverticulosis

Show Answer

Correct Answer » B Explanation

Ans:B. Colonic Carcinoma.

Image Shows:

• Double contrast enema demonstrates a severe stricture with typical apple core lesion (arrows) in the colon .

COLONIC CARCINOMA

• The location of colonic carcinoma, in descending order of frequency, is: rectum > sigmoid > transverse > ascending > caecum

The two most common radiological appearances are:

• Apple-core (ulcerating annular lesion)

• Fungating (multilobular protruding lesion)

• Double contrast enema shows the typical fungating mass
  (arrows) with mildly irregular surface arising
  from the posterior wall of the rectum.