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Saturday, April 14, 2012

CASE: CA RECTUM WITH OBSTRUCTION

Middle aged male with pain in abdomen , distension, obstipation for 4 days
known case of DM / HTN on Rx.

Tachycardia, hypo tension at the time of presentation , CT DONE after resuscitation
S/o large bowel obstruction ? ca rectum, with colonic diameter more than 11 cm





Emergency colonoscopy done s/o tight growth in upper rectum, scope not negotiable, tube not passed

SURGERY: Emergency surgery : (T M E) Anterior resection with Hartmann's procedure, closing of distal stump, proximal diverting colostomy.
discharged on POD 8.

HPE: moderately diff. adeno ca rectum with 22/22 nodes positive, T3, N2. M0., All resection margins are free with distal being 7 cm away.

patient now subjected to adjuvant chemo radio..