Left-sided colonic obstruction due to brid ileus and coexisting right colon cancer without palpable mass

This is a case of a 70-year-old man presenting with caecum perforation and obstruction in the splenic flexure. During surgical exploration, calcified lymph nodes were found in the mesocolon. Right hemicolectomy was performed according to oncological surgical principles. Pathology revealed a 1 cm tum...

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Bibliographic Details
Published in:Turkish journal of colorectal disease 2018-06, Vol.28 (2), p.99-101
Main Authors: Beksaç,Özgü Kemal, Üstüner,Mehmet Akif, Çetin,Bahadır
Format: Article
Language:English
Subjects:
adhesion ileus
Calcification
Colon perforation
colonic obstruction
Colorectal cancer
emergency colon tumour resection
Intestinal obstruction
Lymphatic system
Metastasis
Tıp
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Summary:This is a case of a 70-year-old man presenting with caecum perforation and obstruction in the splenic flexure. During surgical exploration, calcified lymph nodes were found in the mesocolon. Right hemicolectomy was performed according to oncological surgical principles. Pathology revealed a 1 cm tumor of moderately differentiated adenocarcinoma in the caecum and 3 metastatic lymph nodes. Two weeks after discharge, pulmonary thromboembolism was diagnosed and was successfully treated. Chemotherapy had to be delayed during the thromboembolic event. The patient is currently alive but has three millimetric metastatic nodules in the liver and left lung. While right colon perforations almost always arise from a distally located obstruction, there may be co-existing pathologies. Palpable calcified lymph nodes in the mesocolon are a good indication for cancer. Therefore, an extended resection according to oncologic surgical principles is more beneficial if malignancy is suspected. The patient may not always be suitable for a completion surgery.
ISSN:2536-4898
2536-4901
DOI:10.4274/tjcd.90377