Abdominal examination is normal in early cases. Occasion- ally, in patients with stenosing tumours at the rectosigmoid junction, signs of subacute large bowel obstruction may be present, with abdominal distension. If large-volume liver metastases are present, an enlarged liver may be palpable along with other signs, such as cachexia. Occasionally, it may be possible to elicit ascites if there is widespread peritoneal dissemination.