This page has recordings of sessions delivered in the last week.
Session 53. Colorectal peritoneal metastases and Pseudomyxoma Peritonei: Missed cases 30/4/25
Case 6:
Is it operable – Yes (Disease limited mostly to midline abdomen – can redo anastamosis. No clear small bowel involvement)
Multiple lesions along the midline rectus abdominis muscle with one abutting the ileocolic anastamsois.
Depostis adjacnet to the greater curve of the stomach.
Omental/anterior peritoneal deposits with lesion in the LUQ abutting (but not clearly involving) a small bowel loop (Small bowel contrast would have been useful here!)
Case 9:
Where is the primary? - Appendix
Look for the calcification.
Patient has bilateral krukenbergs with calcified blind ending structue within the midline. Can trace this back to the caecal pole = Mucinous tumour of the appendix.
Further depostis – bilateral subphrenic spaces with scallopiong of liver, large omental deposits LUQ and RLQ/right paracolic gutter, pelvic cul-de-sac
Case 10:
Where is the primary? Is there any peritoneal disease?
Three primaries:
1. Small bowel jejunum (with small bowel obstruction)
2. Rectosigmoid
3. Distended appendix tumour
+ Omental lesions lower abdomen (left of midline)
Learning point – Always look for the appendix! Even if you have seen another primary.
