Carcinoma of the small intestine and colon as a complication of Crohn disease: radiologic manifestations.

Abstract

Ba examinations of the large and small bowel were analyzed in 6 of 7 patients who had adenocarcinoma in areas of the intestine affected with Crohn disease; radiographic changes were correlated with clinical, surgical and pathologic findings. Radiographic examinations were available in 5 of these patients at the time of diagnosis of tumor. Two of the 5 patients demonstrated classic radiographic changes associated with carcinoma. In the other 3 cases, the radiographic changes were atypial for carcinoma and demonstrated progression of disease over time to include more portions of the bowel and presence of fistulas, strictures and obstruction. The most frequent clinical presentation of adenocarcinoma in these patients was a recrudescence of symptoms after a long quiescent period. In patients with long-standing Crohn disease plus these clinical features and the above radiographic findings, the diagnosis of a coexisting carcinoma should be considered.