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February 17, 1975

The Radiologic Diagnosis

Author Affiliations

From the Veterans Administration Hospital (Dr. Fenlon), San Francisco, and the Department of Radiology, University of California at San Francisco.

JAMA. 1975;231(7):752-755. doi:10.1001/jama.1975.03240190056023

RADIOLOGIC techniques play an important role in the diagnostic evaluation for carcinoma of the colon. It is essential, therefore, to understand these methods thoroughly.

PLAIN FILM EXAMINATION  Approximately 13% to 25% of patients with carcinoma of the colon are first encountered with partial or complete obstruction of the bowel. Carcinoma of the colon, rectum, and anus is the most common cause of large-bowel obstruction.1 Plain film examination of the abdomen, with supine and erect views, can provide a strong presumptive diagnosis of carcinoma of the colon when complete obstruction is present. Exploratory laparotomy is commonly performed without further radiologic studies, although a barium enema examination would localize the site of obstruction accurately.

BARIUM ENEMA EXAMINATION  For lesions beyond the reach of the sigmoidoscope, the barium enema examination is often the single source of objective information on which important clinical decisions are based.The common roentgenographic appearances of carcinoma of