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Sunday, September 9, 2012

CASES: CA colon with intestinal obstructions

CASE 1. 75 yrs female with pain in abdomen and distension and vomiting
CBC: Hb 6.5., suspected diagnosis was ca ascending colon
CECT: S/o  same findings

surgery: EXTENDED RT hemicolectomy with cholecystectomy and primary anastomosis of ileum to transverse colon and lymphadinectomy

patient was discharged on POD 9.

CASE 2. 70 Yrs female with pain in abdomen and constipation with distension...x ray s/o  dilated colon...and small bowel loops..

CECT: s/o pseudo obstruction...
patient detoriated and suddenly collapsed in conservative trial ...x ray : was done s/o free gas under diaphargm..immediately explored...and found to have colonic perforation with napkin ring structure growth in descending colon sigmoid  junction and ischemic whole colon with diameter of more than 10 cm...with multiple perforations....total colectomy was done with ileostomy but unfortunately pt did not make...