Angiographic diagnosis of carcinoma of the cecum

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SELECTIVE angiography has proved to be useful in the diagnosis of intraabdominal neoplasm, particularly tumors of the pancreas, stomach, and liver.1–4 The procedure also has been helpful in diagnosing tumors of the small and large intestine and their mesenteries. Angiography has often been used for investigation of a known disease process or abdominal mass. However, because of the more simply performed barium studies, angiography is not often considered a practical aid in diagnosing tumors in the small and the large intestine. In the colon, the cecum is most likely to harbor a tumor that escapes detection by conventional examination. In this region, good detail on barium studies is often limited by inadequate cleansing of the intestine or by the emptying of small-bowel contents into the cecum. Often barium enema examinations of the colon are inconclusive although the patients have clinical signs and symptoms strongly suggestive of cecal cancer. Serial barium enema studies finally reveal the presence of a tumor that then can be retrospectively identified, usually smaller in size than that shown on a previous colon examination.

The following case report illustrates a common problem in diagnosis of carcinoma of the cecum which finally was identified by means of selective superior mesenteric arteriography.

Report of a Case

A 68-year-old woman was first admitted to the Cleveland Clinic Hospital on March 15, 1966, because of persistent nausea, anorexia, and abdominal cramps in the mid abdomen for the previous two years. During this period she had lost 18 pounds. Coincident with the . . .



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