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Colonic Narrowing
Synchronous Adenocarcinom

DDX Colonic Narrowing
Tumor /Trauma- adenocarcinom, carcinoid, serosal mets, endometriosis, caustic and cathartic agents, adhesions
Infection/ Inflammatory- diverticulitis, Tuberculosis, XRT
Congenital- IBD
Metabolic- amyloidosis, pelvic lipomatosis
Vascular- ischemia
Most common GI tract cancer, 2nd most common cancer
Risk factors: personal history or family history of colon/ endometrial/ breast cancer, IBD, Polyposes, Environmental, ureterosigmoidoscopy
Screening: age > 50 annual fecal occult blood test and q2-3y sigmoidoscopy/ BE
Duke Classification: A insitu, B local extension, C lymph nodes, D distant mets
Remember DDX coned cecum: infection (TB, CMV, Actinomyces, Blasto, Typhoid, Yersinia, Amebiasis), inflammation (IBD, appendicitis, typhlitis, diverticulitis), tumor (carcinoma, met)
Duke DDX Extrinsic Colonic Masses
Neoplastic- peritoneal carcinomatosis, peritoneal mets, pseudomyxoma, endometrioma
Nonneoplastic- appendicitis, mucocele, cholecystitis, pancreatitis, PID, TOA