COLORECTAL CARCINOMA;

Frequency in adult patients presenting with large bowel obstruction.

Abstract

Introduction: Large bowel obstruction due to colorectal carcinoma occurs in up to 20% of the patients and usually
2-4 accompanied by morbidity and mortality . Almost 25 % deaths occur post-operatively following surgery for colorectal cancers occur in
1 those who initially present with obstruction . Usually elderly patients with associated co-morbidities presents with bowel obstruction.
Objective: Find out the frequency of colorectal cancers in patients presenting with large bowel obstruction. Design: Prospective cross
sectional study. Setting: Shaikh Zayed Hospital Lahore. Period: from 31st December 2010 to 31st December 2012. Materials &
Methods: A total 20 patients were presented with large bowel obstruction with the age ranges between 40 to 70 years. All the 20 patients
underwent routine haematological and biochemical tests. In these patients an abdominal x-ray in a supine or standing position was taken
and dilated loops of bowel, air-fluid interfaces, or both was observed then Contrast radiography(Barium/gastrograffin) was done to
define the site and extent of the obstruction. An abdominal computed tomography scan was done to evaluate the extent of the disease.
Colonoscopy was also carried out in the patients with colorectal cancers to find out the size and location of the tumor and biopsy taken by
colonoscope. Results: 12 patients out of 20 presented with large bowel obstruction were diagnosed to have a colorectal cancers and the
age ranges from 60 to 70 years. The 8 patients were diagnosed to have a sigmoid colonic tumour and 4 patients were suffering from a
tumour of recto sigmoid junction. Whereas in rest of the 8 patients the large bowel obstruction was due to other benign causes like
volvulus and intussusception and age range was 50 – 60 years. 6 patients were suffering from sigmoid volvulus and remaining 2 had
colo-colic intussusception. Conclusions: It is concluded that the major cause of the large bowel obstruction is the left sided colorectal
cancers the tumours of recto sigmoid junction.