Middle aged male with recurrent colicky pain in abdomen for more than 1 year,DM, HTN.
CECT: S/o growth near splenic flexure with dilated proximal large bowel. and an enlarged single node near splenic flexure, rest NAD.
COLONOSCOPY: S/o non negotiable growth in splenic flexure, with two polyps in descending colon, bx taken.
Plan : Lap assisted redical left hemicolectomy and intra op proximal colonoscopy to look for polyps..sos total colectomy..
SURGERY: LAP Assisted radical left hemicolectomy done, intra op proximal colonoscopy done s/o 9 more polyps in proximal colon of variable size and type. frozen sent from two of them..s/o moderate to severe dysplasia in both.
TOTAL abdominal colectomy done with ileo rectal anastomosis and proximal diverting ileostomy.
HPE: T3, N1, G1 adeno ca of colon, (1/16 nodes positive), all 11 polyps showed moderate to severe dysplasia.., ALL resection margins are free of tumor.
pt discharged on POD 10.