Clinical Case Database / Category: Case Based Discussion

Colorectal carcinoma

Publication details

JJ Crosbie, Mr G Buchanan
Foundation Years Journal, volume 2, issue 7, p.34 (123Doc Education, London, September 2008)

Abstract

A 78-year-old male presented to Accident and Emergency department with a 4-day history of abdominal distension, vomiting and constipation. He had a background history of known diverticular disease. In the last 6 weeks, he had increasing symptoms of loose and frequent bowel motions. He had a history of hypertension and migraine. His sister had a right hemicolectomy for caecal adenocarcinoma at age 65 years. His initial observations showed a temperature of 37.5C, heart rate 110/min, blood pressure 158/87 and respiratory rate 16/min. Blood tests showed a haemoglobin 15.3 g/dl; WBC 14×10^9/L; platelets 667×10^9/L; urea 9.4 mmol/L and a creatinine 123 µmol/L. His plain abdominal X-ray showed signs of large bowel obstruction. He subsequently had a CT scan of the abdomen which showed an obstructing sigmoid carcinoma with no evidence of perforation or metastatic disease. Following his initial resuscitation, he had a colonic stent inserted to relieve the obstruction. Four days later, he had an elective anterior resection with primary anastomosis. He was discharged home 1 week later. Histology confirmed a Dukes B adenocarcinoma of the sigmoid.

Access the Clinical Cases Database

A subscription is required to read the full article. Please subscribe using one of the options below.

Authors

JJ Crosbie

Department of Colorectal Surgery
Charing Cross Hospital
London

Mr G Buchanan

Department of Colorectal Surgery
Charing Cross Hospital
London

References

1. Cancer Research UK. Statistics on colorectal cancer. Available at http://www.cancerresearchuk.org/cancerstats/typs/bowel
2. Watt AM, Faragher IG, Griffin TT, Rieger NA, Maddern GJ. Self-expanding metallic stents for relieving malignant colorectal obstruction: a systematic review. Ann Surg, July 2007, 246(1):24–30.
3. Dauphine CE, Tan P, Beart RW Jr, Vukasin P, Cohen H, Corman ML. Placement of self-expanding metal stents for acute malignant large bowel obstruction: a collective review. Ann Surg Oncol, July 2002, 9(6):574–579.
4. Tilney HS, Lovegrove RE, Purkayastha S, Weston-Petrides GK, Darzi AW, Tekkis PP, Heriot AG. A Comparison of colonic stenting and open surgery for malignant large bowel obstruction. Surg Endosc, February 2007, 21(2):225–233.
5. Dastur JK, Forshaw MJ, Modarai B, Solkar MM, Raymond T, Parker MC. Comparison of short and long-term outcomes following either insertion of self-expanding metallic stents or emergency surgery in malignant large bowel obstruction. Tech Coloproctol, March 2008, 1(2):51–55.
6. Davies RJ, D’Sa IB, Lucarotti ME, Fowler AL, Birch P, Cook TA. Bowel function following insertion of self-expanding metallic stents for palliation of colorectal cancer. Colorectal Dis, May 2005, 7(3):251–253.

Disclaimers

Conflict Of Interest

The Journal requires that authors disclose any potential conflict of interest that they may have. This is clearly stated in the Journal’s published “Guidelines for Authors”. The Journal follows the Guidelines against Conflict of Interest published in the Uniform Requirements for Manuscripts Submitted to Biomedical Journals (http://www.icmje.org/urm_full.pdf).

Financial Statement

The authors of this article have not been paid. The Journal is financed by subscriptions and advertising. The Journal does not receive money from any other sources. The decision to accept or refuse this article for publication was free from financial considerations and was solely the responsibility of the Editorial Panel and Editor-in-Chief.

Patient Consent statement

All pictures and investigations shown in this article are shown with the patients’ consent. We require Authors to maintain patients’ anonymity and to obtain consent to report investigations and pictures involving human subjects when anonymity may be compromised. The Journal follows the Guidelines of the Uniform Requirements for Manuscripts (http://www.icmje.org/urm_full.pdf). The Journal requires in its Guidelines for Authors a statement from Authors that “the subject gave informed consent”.

Animal & Human Rights

When reporting experiments on human subjects, the Journal requires authors to indicate whether the procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the HelsinkiDeclaration of 1975, as revised in 2008.

About the Clinical Cases Database

T​he Foundation Years Clinical Cases Database is​ a selection of 600 peer-reviewed clinical cases in the field of patient safety and clinical practice, specifically focused on the clinical information needs of junior doctors, based around the Foundation Year Curriculum programme (MMC). The cases have been chosen to align with the Foundation Year Curriculum.

The database is fully searchable, or can be browsed by medical specialty. Abstracts can be read free of charge, however a subscription is required in order to read the complete cases.