Saturday, April 14, 2012

CASE: Multiple polyposis coli with ca colon

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.