Large bowel obstruction - due to a colonic tumour

Case contributed by Dr Ian Bickle

Presentation

A young female presents with a distended abdomen and altered bowel habit.

Patient Data

Age: 25
Gender: Female

Stenosing tumour in the hepatic flexure, with foci of calcification within, resulting in a high grade large bowel obstruction.

The small bowel is also distended in keeping with an incompetent ileocaecal valve.

Case Discussion

Colorectal carcinoma is one of the commonest primary tumours, occurring largely in the older patient demographic.  It can however effect those under 30 years of age, especially when associated with familial or syndromic conditions, such as familial adenomatous polyposis syndrome.

It remains the commonest cause of large bowel obstruction.  In some patients, who typically present later, the ileocaecal valve may be incompetent resulting in an associated small bowel obstruction (it 'deflates' itself into the small bowel first so 'buying' time before overwhelming symptoms for the patient).

This patients histology identified a mucinous adenocarcinoma. This histological subtype will often contain calcification in both the primary and distant metastases.

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Case information

rID: 32613
Case created: 5th Dec 2014
Last edited: 11th Sep 2015
Inclusion in quiz mode: Included

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