CT colonography is a powerful tool which is used for both screening of bowel cancer as well as imaging in symptomatic patients. The companion UK Special Interest Group in Gastrointestinal and Abdominal Radiology (SIGGAR) trials have shown CT colonography as being more superior as compared to barium enema and colonoscopy in patients with symptoms suggestive of colon cancer. Recently, SIGGAR investigators, in Lancet ^1,2, have reported the findings of two trials which indicate that CT colonography is more sensitive than barium enema and provides a less invasive alternative.

Our case is a very good example highlighting the sensitivity that CT colonography can afford in terms of further characterizing suspicious lesions. This in turn allows us to confidently choose the best clinical or surgical approach for the patient. In our case after the CT colonography, we were confident of the fact that we were dealing with a single site of disease in the rectum. This allowed us to recommend the surgeons to carry out an AP resection.

Contribution in writing and proofreading this case was also made by Dr Milan Sapundzieski, Consultant Radiologists, Pennine Acute Hospital.