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Large bowel obstruction

Case contributed by: Dr Varun Babu

Presentation:

Young lady presented with symptoms of acute abdominal pain since 3 days. Outside evaluation revealed doubtful renal calculi and was given symptomatic treatment. Since pain was not subsiding, she was referred to a higher centre. Bilious vomiting was observed at the time of sonographic study of abdomen.

Patient Data:

Age: 38
Gender: Female

Abdominal X ray

Modality: X-ray
Modality: CT

Case Discussion:

Colonoscopy revealed a lumen occluding circumferential proliferative growth in the descending colon. 

Microscopic Description:Section shows fragments of large intestinal mucosa containing part of an ulcerating neoplasm with villous architecture in places lined by cells displaying nuclear crowding, stratification and hyperchromasia, variably conspicious nucleoli and frequent mitosis. Disorganised glands with luminal necrosis and moderate to severe degree of cytological atypia and apical mitosis are present in the lamina propria and also between muscularis mucosal fibres. There is associated inflammation and desmoplasia

Colonic biopsy conclusion: Moderately differentiated colon adenocarcinoma.

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