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)


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.

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JJ Crosbie

Department of Colorectal Surgery
Charing Cross Hospital

Mr G Buchanan

Department of Colorectal Surgery
Charing Cross Hospital


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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.

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