Objectives

1- To review the common presentations of abdominal gossypibomas and their typical as well as some rare clinical manifestations.

2- To illustrate the imaging features using a multimodality approach.

3- To discuss the most important complicaitons and differential diagnosis.

Background

Textiloma and gossypiboma are non-medical terms used to describe a mass of cotton matrix that is left behind in a body cavity during an operation. Strictly speaking and by etymology, the term gossypiboma, should be reserved for masses produced by retained cotton or woven fabrics. They are most frequently diagnosed in the intra-abdominal cavity. Gossypibomas may present at any time , from immediately postoperatively to several decades after initial surgery. Imaging features depend on the time since surgery, the presence of secondary infection, communication of the gossypiboma with hollow viscus or external skin wound, and the modality of the radiological investigation.

Imaging findings OR Procedure findings

In this exhibit the authors discuss the most frequent clinical manifestations and some less common presentations of abdominal gossypibomas. The radiographic and sonographic appearance as well as the CT and MR features of these masses are addressed emphasizing the possible complicaitons and differential diagnosis. The authors illustrate the imaging findings with surgical confirmed cases from their personal archives.

Conclusion

Gossypibomas are not rare and their diagnosis are not often easy. Delayed diagnosis can be problematic and radiologists should be aware of the common as well as unusual appearances of gossypibomas in order to make a correct diagnosis in the appropriate clinical setting.

Objectives

1. To review the anatomic structures which are essential for focal staging of rectal cancer, such as the mesorectal fascia and the intersphincteric plane.

2. To address the accurate MRI protocol in order to obtain the best images for staging low rectal cancer.

3. To discuss and illustrate the imaging findings of low rectal tumors using MR and schematic drawings.

Background

Rectal cancer comprises approximately one third of all colorectal carcinomas, and of these approximately one third correspond to low rectal cancer. Lower rectal tumors appear to be more aggressive and are associated with high rates of positive radial margins, local recurrence, and mortality. Magnetic resonance imaging (MRI) is the best technology for evaluating rectal cancer in terms of local extent and recurrence and a sensitive and specific tool for tumor staging.

Imaging findings OR Procedure findings

In this presentation the authors will discuss the most important anatomical landmarks for staging these tumors. Imaging features such as distance of tumour to the potential circumferential margin, presence of tumour within the extramural rectal vessels, relationship to the intersphincteric plane in low rectal tumours and to pelvic compartments in advanced disease will be addressed. The MRI protocol will be discussed and illustrated using both MRI and schematic drawings. Cases from the authors' achives will be used to illustrate the imaging findings.

Conclusion

MRI has a high value for guiding rectal cancer treatment, especially in cases of lower rectal cancer and radiologists should be familiar with the complex anatomy of this region and the important imaging features for preoperative staging.