Obstructing colon cancer with gas in cecal wall

Case contributed by Dr Vikas Shah

Presentation

3 days of increasing abdominal distension and not opening bowels. Iron deficiency anemia.

Patient Data

Age: 50 years
Gender: Male

Irregular thickening of the wall of the colon is seen at the splenic flexure with adjacent nodular soft tissue. The colon distal to this is collapsed but proximally is markedly distended. In particular, the cecum is very distended. A small volume of free fluid is seen. There are bubbles of gas in the cecal wall. No suspicious liver lesions.

Case Discussion

The splenic flexure lesion is causing large bowel obstruction, and the gas in the cecal wall is worrying as it implies that the cecum is becoming ischemic due to the obstruction. An extended right hemicolectomy confirmed an adenocarcinoma of the splenic flexure and cecal ischemia, but no perforation.

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Case information

rID: 54762
Published: 26th Aug 2017
Last edited: 15th Oct 2019
Inclusion in quiz mode: Included

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