Small bowel obstruction due to colorectal cancer recurrence

Case contributed by Dr Vikas Shah

Presentation

Previous surgery for rectal cancer, including ileostomy and colostomy. Also splenectomy. Now has 2 days of vomiting and abdominal distension. ?adhesional obstruction

Patient Data

Age: 70 years
Gender: Male
CT

CT abdomen and pelvis

Right-sided ileostomy and left-sided colostomy, splenectomy.

Acute high-grade small bowel obstruction with a jejunal loop pinched by a soft tissue deposit in the left side of the abdomen. This soft tissue mass extends into the abdominal wall musculature and the anterior surface of the iliacus muscle. A further irregularly marginated soft tissue mass is present anteroinferior to the tail of the pancreas.

Case Discussion

When someone with a history of surgery for colorectal cancer presents with symptoms and signs of bowel obstruction, the principal diagnoses to be considered are adhesions, hernia (either a co-incidental inguinal or femoral hernia, or related to the surgery such as an incisional hernia), and recurrence. 

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Case information

rID: 56071
Case created: 9th Oct 2017
Last edited: 25th Oct 2017
Inclusion in quiz mode: Included

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