role of barium enema in the evaluation of morphologic and histopathologic characteristics of colorectal tumours

ABSTRACT

During a 9-months period [Sep 1991-Jun 1992] clinical, radiographic, endoscopic, surgical and histopathologic findings of 25 patients with colorectal tumours were reviewed retrospectively. To assess the current status of barium enema examination as the initial diagnostic procedure for the detection of suspected colorectal tumours and to determine the relationship between their morphologic and histopathologic characteristics. Six patients [24%] had lesions proximal to the splenic flexure and 19 [76%] patients had more distal lesions predominantly [68%] in the rectosigmoid region. Large [>4 cm] intraluminal fungating cancers [34.50% [9 of 25 patients]] and long [> 4 cm] rigid neoplastic strictures [30.75% [8 of 29 patients]] were among the commonest morphologic forms of colorectal tumours. Four [[out of 25] [15.40%]] patients had typical annular carcinoma; two [[out of 25] [7.70%]] patients had small [2-4 cm] polypoidal growths and one [[out of 25] [3.85%]] had a flat marginal lesion. One patient had double lesions so two polyps [7.70%] were also detected. The minimum size of the lesion noted was 1.8 cm and maximum was 16.2 cm. Histopathologic reports revealed 2 adenomatous polyps; 2 metastatic cancers; on squamous sell carcinoma and 20 cases of primary colorectal adenocarcinomas; 2 [10%] were well-differentiated; 9 [45%] moderately differentiated; and 9 [45%] poorly differentiated. Three patients had Dukes stage A lesions; 10 had Dukes stage B lesions; 8 had Dukes stage C lesions; and 4 had Dukes stage D lesions. Long strictures and annular carcinomas were more likely to extend to the stroma and spread to the lymph nodes. The results showed that double contrast barium enema examination is an easy and valuable initial diagnostic procedure for the detection of suspected colorectal tumours and is also significantly helpful in predicting their morphologic and histopathologic characteristics