Malignant large bowel obstruction

Case contributed by Dr Ian Bickle


A short history of increasing abdominal distension. No bowel motion for 2 days. Obstruction?

Patient Data

Age: 55 years
Gender: Female

Short segment circumferential tumor of the sigmoid colon.   The rectal is collapsed.

The proximal large bowel is distended with faeculant matter.  Small bowel normal in caliber.

Fatty liver.  The solid organs are otherwise normal.

No pelvic or para-aortic lymphadenopathy.

Right basal atelectasis.

Case Discussion

This is your bread and butter case.   Typical appearances of a common pathology rather than a wow unusual case.

It is bread and butter in terms of pathology, but also the sort of on-call case that creeps up fairly often as a surgical abdomen with large bowel obstruction.

Be sure to check for a tumoral perforation and not to miss any distant metastases.

The need for completion staging of the chest with CT is also worthy of mention.

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Case information

rID: 58554
Published: 23rd Feb 2018
Last edited: 23rd Feb 2018
Tag: ripas2
Inclusion in quiz mode: Included

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