• Imaging of acute small bowel pathologies in oncology patients in the ER part I: the role of Computed Tomography (CT) for the evaluation of Tumor and infections

    Hajra Arshad, Satomi Kawamoto, Linda C Chu, Elliot K Fishman

    Emerg Radiol. 2025 Jun;32(3):463-474. doi: 10.1007/s10140-025-02341-6. Epub 2025 Apr 14.

    Abstract

    Acute abdominal complaints constitute up to 40% of all emergency department (ED) presentations in oncology patients due to a multitude of causes. Small bowel pathologies present a diagnostic challenge due to their diverse range and frequently overlapping clinical presentation. In oncology patients, structural changes resulting from tumor growth, surgery and treatment effects can further complicate the diagnostic process. Due to a weakened immune system, oncology patients are also highly susceptible to infections of the gastrointestinal tract (GIT). Traditional computed tomography (CT) scans are used as the gold standard diagnostic modality. However, three-dimensional (3D) postprocessing techniques including maximal intensity projection (MIP), volume rendering (VR) and cinematic rendering (CR) have been employed to aid image evaluation. For a balanced and organized approach to describe diagnostic challenges in this complex population, we have divided the pictorial essay into two parts. The first part focuses on tumor- and infection-associated causes, as summarized below in the visual abstract. The second part will address treatment-related complications, including chemotherapy, radiotherapy, immunotherapy, graft-versus-host disease and post-surgical complications.