CT Abdomen and Pelvis – Contrast Enhanced
Indication: Metastatic colorectal cancer. Suspected malignant bowel obstruction.

Findings:
Dilated small and large bowel loops with multiple transition points. Obstruction at mid-descending colon, transverse colon and distal ileum, consistent with multifocal malignant obstruction. Moderate ascites and diffuse peritoneal thickening suggest peritoneal carcinomatosis. Omental caking and known liver metastases are unchanged. No free air or signs of perforation.
The general surgical team have read the reports and they have decided that the patient is not a suitable candidate for surgical intervention.

Suggest why, other than patient co-morbidities, this patient is not a suitable candidate for surgical intervention? (1 x mark)

What is the intention of treatment for her current metastatic bowel cancer, and briefly describe the role of this intention? (2 x ½ mark)

Oncology & Palliative Care