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in UW it says that when a liver metastasis is found on imaging or by clues like : firm hepatomegaly, microcytic anemia ( occult blood), cholestasis and pleural effusion -----> co CT abdomen with IV contrast
isn't colon cancer is the most common especially when there's occult bleeding and we should do colonoscopy ? :confused:
 

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I think you need to confirm that there are actually multiple metastasic nodules in the liver first, before doing a colonoscopy. Also, you would be looking at how much has the cancer metastasized. Then do the colonoscopy to confirm that the metastasis comes from colon. Besides, if you did a colonoscpy first, you would end up doing the CT scan anyway, to see the extent of the metastatic disease.

And yes, colon cancer does metastasis to liver almost always.
 
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