Frail lady in her eighties presented to her GP with change of bowel action.
Colonoscopy shows 5cm low rectal tumour.
Transanal excision performed – ie surgery via anal canal to resect the tumour alone, not needing a laparotomy.
Histology: Rectal adenoma
A most interesting case out of the textbook.
Patient in the 20s walked into the clinic. Has been referred to me for a colonoscopy.
First thing I noticed was the reddish nodules on the shins of both the legs. The patient says that these has been quite painful. The pain had thougth this was due to mosquito bites or some sort of reaction to insect bites. (Clinically on examination, this was consistent with erythema nodosum)
Further history taking reveals the patient has been having diarrhoea. The patient had also been feeling tired.
Colonoscopy was performed and it showed proctitis as well as distal colitis. Biospsies were taken – histology was initially reported as normal but when I queired it with the pathologist, a second opinion was sought and the consensus opinion was that is was consistent with ulcerative colitis.
How long is it before someone would present with bowel cancer?
This varies from person to person – these days, the sooner one brings this to the doctors attention, the sooner this can be looked at.
Recently a patient in the 70s who has been on holidays travelling around Australia presented to his local GP complaining of a change of bowel action. He was investigated and found to be severely anaemic. He was sent to the Emergency department as he has had increasing difficulty opening his bowels.
On examination, he was found to have a low rectal cancer on rectal examination. Further investigations showed that he has lung metastates.
He went on to have a resection and permanent stoma.
This is a difficult question to answer for the individual.
Just last month a man in his 40s was seeing his GP for a skin problem when the GP suggested that he take the test. The faecal occult blood test came back positive – in fact, positive on all specimen. He was then referred for a colonoscopy.
On colonoscopy, a bowel cancer in the caecum was found.
He subsequently underwent a bowel resection. The pathology showed that is was a fairly advanced cancer – with lymph glands involved. Further scans suggest the possibility of spread to the liver already..