Carcinoma
of Colon
Aetiology
1.Age:Elderly.
2.Sex:Male>Female.
3.Ulcerative colitis.
4.Regional enteritis.
Clinical
features
1.There is progressive
constipation.sometimes there is
diarrhoea alternating with constipation.
2.Abdominal colic.
3.There is bleeding per rectum if the
cancer has ulcerated into the lumen of the colon.
4.If the cancer is high upin the bowel,here
is ocultblood in stools.
5.Some patients present with intestinal
obstruction as the first symptom of the disease.
.Constipation.
.Abdominal distention.
.Abdominal colic.
.Vomiting,which becomes faecal
later on.
6.Advanced cases show malignant cachexia
and anaemia.
Investigations
Investigations
for Carcinoma of Colon
|
Test |
Findings |
|
Stools routine |
Frank or occult blood. |
|
Haemoglobin |
Low. |
|
Colonoscopy |
The cancer is seen. A biopsy can be obtained for histopathological diagnosis. |
|
Sigmoidoscopy |
As above. |
|
Barium enema |
There is mucosal irregularity and extravasation of barium in case
of an ulcerative growth,and an irregular filling defect in case of a
cauliflower-like growth. |
Treatment
The cancerous growth has to be removed
surgically.various types of operations done for carcinoma of the colon are as
in the following table:-
Operation for
Carcinoma of Colon
|
Operation |
Features |
|
Colostomy |
After resection of the affected segment of the colon, the proximal
cut end of the colon is opened on the abadominal wall,to which an ostomy bag
is attached for collection of
stools,e.g.transverse colostomy. |
|
Caecostomy |
The caecum is opened on the anterior abdominal wall for drainage
of stools. |
|
Hemicolectomy |
Affected half of the colon,left or right,is removed surgically. |
Preoperative
care for colectomy
1.Preparation is done as for exploratory
laparotomy. In addition, the following preparation are done.
2.Low residue diet is given.
3.Liquid paraffin is given 15ml 8 hourly
orally.
4.High bowel wash is given to remove all
faecal matter from it.
5.The organism in the colon are removed
with sulphasuxidine 2g 4 hourly orally. Retention enema bacitracin 100000units
and nystatin 500000 units are also given 6 hourly orally.
6.Soap water enema is given on the morning
of the operation.
Postoperative
Care
1.Treatment is given as aftr an exploratory
laparotomy. In addition, the following measures are taken.
2.Enema is never given.
3.No liquids are given per rectum.
4. Oral liquids are started as early as
possible.
5.Liquid paraffin is given 15 ml 8 hourly
orally from the second day.
6.Flatus tube is passed 4 hourly to remove
all gas in the colon.
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