Surgical approach of megacecum secondary to descending colon tumor

Authors

DOI:

https://doi.org/10.11606/issn.2176-7262.rmrp.2022.179109

Keywords:

Colectomy, Intestinal obstruction, Acute abdomen, Megacolon, Colorectal neoplasms

Abstract

            Intestinal obstruction is the most frequent clinical manifestation of colon tumors, most of which are located in the descending and recto-sigmoid colon. Emergency bowel obstruction surgery is associated with high mortality and morbidity risks and the ideal approach remains controversial. Multi-stage procedures and the use of stents as bridges for surgery are promising options. A case of a 61-year-old patient with an acute obstructive abdomen secondary to colorectal neoplasm is presented, with emphasis on its diagnosis and treatment.                                                                                  

Downloads

Download data is not yet available.

Author Biographies

  • Joana Marques Maia Souza, Universidade Federal do Pampa, Uruguaiana (RS), Brasil.

    Acadêmica do curso de Medicina

  • André Luiz Girotto, Universidade Federal de Rio Grande, Rio Grande (RS), Brasil.

    Acadêmico do curso de Medicina

  • Caio Cesar di Elias, Associação de Caridade Santa Casa do Rio Grande (ACSCRG), Rio Grande (RS), Brasil.

    Médico Residente do Programa de Cirurgia Geral

  • Carlos Magno Pereira Filho, Associação de Caridade Santa Casa do Rio Grande (ACSCRG), Rio Grande (RS), Brasil.

    Médico Residente do Programa de Cirurgia Geral

  • Filipe Geannichini Rodrigues, Associação de Caridade Santa Casa do Rio Grande (ACSCRG), Rio Grande (RS), Brasil.

    Médico Cirurgião Geral

References

Ramos R, dos-Reis L, Teixeira B, Andrade I, Sulzbach J, Leal R. Colon cancer surgery in patients operated on an emergency basis. Revista do Colégio Brasileiro de Cirurgiões. 2017;44(5):465-470.

Anyaegbuna C, Apostolopoulos A, Patel H. Bowel perforation in chronic idiopathic megarectum and megacolon. BMJ Case Reports. 2018;:bcr-2018-225406.

Núñez Ortiz A, Trigo Salado C, de la Cruz Ramírez M, Márquez Galán J, Herrera Justiniano J, Leo Carnerero E. Megacolon in inflammatory bowel disease: response to infliximab. Revista Española de Enfermedades Digestivas. 2020;112.

Lee Y, Law W, Chu K, Poon R. Emergency surgery for obstructing colorectal cancers: a comparison between right-sided and left-sided lesions1 1No competing interests declared. Journal of the American College of Surgeons. 2001;192(6):719-725.

Cuda T, Gunnarsson R, de Costa A. Symptoms and diagnostic criteria of acquired Megacolon - a systematic literature review. BMC Gastroenterology. 2018;18(1).

Mankaney G, Sarvepalli S, Arora Z, Kamal A, Lopez R, Vargo J et al. Colonic Decompression Reduces Proximal Acute Colonic Pseudo-obstruction and Related Symptoms. Diseases of the Colon & Rectum. 2020;63(1):60-67.

Wang H, Naghavi M, Allen C, Barber R, Bhutta Z, Carter A et al. Global, regional, and national life expectancy, all-cause mortality, and cause-specific mortality for 249 causes of death, 1980–2015: a systematic analysis for the Global Burden of Disease Study 2015. The Lancet. 2016;388(10053):1459-1544.

Kahi C, Rex D. Bowel obstruction and pseudo-obstruction. Gastroenterology Clinics of North America. 2003;32(4):1229-1247.

Feldman M, Friedman L, Brandt L. Sleisenger and Fordtran's gastrointestinal and liver disease. Philadelphia: Saunders / Elsevier; 2010.

Santos A, Martins L, Brasil A, Pinto S, Neto S, de Oliveira E. Emergency surgery for complicated colorectal cancer in central Brazil. Journal of Coloproctology. 2014;34(2):104-108.

Pisano M, Zorcolo L, Merli C, Cimbanassi S, Poiasina E, Ceresoli M et al. 2017 WSES guidelines on colon and rectal cancer emergencies: obstruction and perforation. World Journal of Emergency Surgery. 2018;13(1).

Lopez-Kostner F, Hool G, Lavery I. MANAGEMENT AND CAUSES OF ACUTE LARGE-BOWEL OBSTRUCTION. Surgical Clinics of North America. 1997;77(6):1265-1290.

Breitenstein S, Rickenbacher A, Berdajs D, Puhan M, Clavien P, Demartines N. Systematic evaluation of surgical strategies for acute malignant left-sided colonic obstruction. British Journal of Surgery. 2007;94(12):1451-1460.

Kracht M, Hay J, Fagniez P, Fingerhut A. Ileocolonic anastomosis after right hemicolectomy for carcinoma: stapled or hand-sewn?. International Journal of Colorectal Disease. 1993;8(1):29-33.

Fielding L, Stewart-Brown S, Blesovsky L. Large-bowel obstruction caused by cancer: a prospective study. BMJ. 1979;2(6189):515-517.

Krstic S, Resanovic V, Alempijevic T, Resanovic A, Sijacki A, Djukic V et al. Hartmann’s procedure vs loop colostomy in the treatment of obstructive rectosigmoid cancer. World Journal of Emergency Surgery. 2014;9(1):52.

Ribeiro I, Moura D, Thompson C, Moura E. Acute abdominal obstruction: Colon stent or emergency surgery? An evidence-based review. World Journal of Gastrointestinal Endoscopy. 2019;11(3):193-208.

Arezzo A, Passera R, Lo Secco G, Verra M, Bonino M, Targarona E et al. Stent as bridge to surgery for left-sided malignant colonic obstruction reduces adverse events and stoma rate compared with emergency surgery: results of a systematic review and meta-analysis of randomized controlled trials. Gastrointestinal Endoscopy. 2017;86(3):416-426.

Sebastian S, Johnston S, Geoghegan T, Torreggiani W, Buckley M. Pooled Analysis of the Efficacy and Safety of Self-Expanding Metal Stenting in Malignant Colorectal Obstruction. The American Journal of Gastroenterology. 2004;99(10):2051-2057.

Published

2022-05-04

Issue

Section

Relato de Caso

How to Cite

1.
Souza JMM, Girotto AL, Elias CC di, Pereira Filho CM, Rodrigues FG. Surgical approach of megacecum secondary to descending colon tumor. Medicina (Ribeirão Preto) [Internet]. 2022 May 4 [cited 2024 Jun. 1];55(1):e-179109. Available from: https://www.periodicos.usp.br/rmrp/article/view/179109