Colonic polyps and colon cancer - Mucosal Immunology · • Colorectal Ca
CLINICAL FEATURES OF RIGHT COLONIC CANCER
-
Upload
arkaprovo-roy -
Category
Health & Medicine
-
view
9 -
download
1
Transcript of CLINICAL FEATURES OF RIGHT COLONIC CANCER
![Page 1: CLINICAL FEATURES OF RIGHT COLONIC CANCER](https://reader035.fdocuments.net/reader035/viewer/2022062900/58ecdef71a28ab4d4b8b46df/html5/thumbnails/1.jpg)
CLINICAL PRESENTATION
ANGANA BHATTACHARJEE 10.03.2017
Malda Medical College
![Page 2: CLINICAL FEATURES OF RIGHT COLONIC CANCER](https://reader035.fdocuments.net/reader035/viewer/2022062900/58ecdef71a28ab4d4b8b46df/html5/thumbnails/2.jpg)
CLINICAL PRESENTATION Patients with COLON CANCER
present in three ways-
VAGUE ABDOMINAL SYMPTOMS AND PALLOR
ASYMPTOMATIC INDIVIDUALS DISCOVERED BY ROUTINE SCREENING
EMERGENCY CONDITION WITH INTESTINAL OBSTRUCTION,PERITONITIS OR RARELY ACUTE GI BLEDDING
![Page 3: CLINICAL FEATURES OF RIGHT COLONIC CANCER](https://reader035.fdocuments.net/reader035/viewer/2022062900/58ecdef71a28ab4d4b8b46df/html5/thumbnails/3.jpg)
CLINICAL PRESENTATION ACCORDING TO ANATOMICAL SITE
RIGHT SIDED COLONIC CANCER
FATIGUE ASSOCIATED WITH ANAEMIA
ALTERED BOWEL HABIT
ABDOMINAL PAIN IN ADVANCED TUMORS
MELENA-DARK TARRY STOOL
RIGHT SIDED ABDOMINAL
MASS
![Page 4: CLINICAL FEATURES OF RIGHT COLONIC CANCER](https://reader035.fdocuments.net/reader035/viewer/2022062900/58ecdef71a28ab4d4b8b46df/html5/thumbnails/4.jpg)
![Page 5: CLINICAL FEATURES OF RIGHT COLONIC CANCER](https://reader035.fdocuments.net/reader035/viewer/2022062900/58ecdef71a28ab4d4b8b46df/html5/thumbnails/5.jpg)
DESCENDING / SIGMOID COLON:
CONSTIPATION ALTERNATING WITH DIARRHOEA,ABDOMINAL
PAIN AND OBSTRUCTIVE SYMPTOMS,MELENA,
PERFORATION
TRANSVERSE: ALTERED BOWEL HABITS,BOWEL
OBSTRUCTION,MELENA
RECTAL:CHANGES IN BOWEL MOVEMENT,RECTAL
FULLNESS,URGENCY,BLEEDING,TENESMUS
ANAL:BLEEDING,DISCHARGE,MASS,
TENDERNESS ON PALPATION,PAIN ON DEFECATION
![Page 6: CLINICAL FEATURES OF RIGHT COLONIC CANCER](https://reader035.fdocuments.net/reader035/viewer/2022062900/58ecdef71a28ab4d4b8b46df/html5/thumbnails/6.jpg)
ADVANCED CANCER PAIN ABDOMEN-COLICKY AND RECURRENT DISTENSION,VOMITTING CONSTIPATION REDUCED BOWEL SOUNDS ON AUSCULTATION DEHYDRATION,TACHYCARDIA, HYPOTENSION PALPABLE LEFT SUPRACLAVICULAR LYMPH
NODES(VIRCHOW’S NODE) METASTATIC FEATURES
![Page 7: CLINICAL FEATURES OF RIGHT COLONIC CANCER](https://reader035.fdocuments.net/reader035/viewer/2022062900/58ecdef71a28ab4d4b8b46df/html5/thumbnails/7.jpg)
COMPLICATIONS STERCORAL ULCER OBSTRUCTION PERFORATION PERITONITIS PERICOLIC ABSCESS
![Page 8: CLINICAL FEATURES OF RIGHT COLONIC CANCER](https://reader035.fdocuments.net/reader035/viewer/2022062900/58ecdef71a28ab4d4b8b46df/html5/thumbnails/8.jpg)
MODE OF SPREAD
LOCAL SPREAD
HEMATOLOGICAL SPREAD
LYMPHATIC SPREAD
![Page 9: CLINICAL FEATURES OF RIGHT COLONIC CANCER](https://reader035.fdocuments.net/reader035/viewer/2022062900/58ecdef71a28ab4d4b8b46df/html5/thumbnails/9.jpg)
LOCAL SPREAD
INVADE THE BLADDER,OBSTRUCT
URETER CAUSING HYDRONEPHROSIS
PERFORATION CAUSING
PERITONITIS,PERICOLIC ABSCESS,FAECAL
FISTULA
ADHERENCE TO PSOAS MUSCLE
POSTERIORLY
INVADE UTERUS,OVARY
ABSCESS IN LATERAL
ABDOMINAL WALL
![Page 10: CLINICAL FEATURES OF RIGHT COLONIC CANCER](https://reader035.fdocuments.net/reader035/viewer/2022062900/58ecdef71a28ab4d4b8b46df/html5/thumbnails/10.jpg)
METASTASIS
![Page 11: CLINICAL FEATURES OF RIGHT COLONIC CANCER](https://reader035.fdocuments.net/reader035/viewer/2022062900/58ecdef71a28ab4d4b8b46df/html5/thumbnails/11.jpg)
LIVER METASTASIS• COMMONEST SITE-SPREADS VIA PORTAL VEINS• ENLARGED LIVER WITH HARD UMBILICATED
NODULES• JAUNDICE• DARK COLOURED URINE• LOSS OF APETITE,WEIGHTLOSS• NAUSEA VOMITTING• CONFUSION• ASCITES
![Page 12: CLINICAL FEATURES OF RIGHT COLONIC CANCER](https://reader035.fdocuments.net/reader035/viewer/2022062900/58ecdef71a28ab4d4b8b46df/html5/thumbnails/12.jpg)
LUNG METASTASIS• COUGH WITH OR WITHOUT
BLOOD • RECURRENT RESPIRATORY
INFECTIONS• HOARSENESS• WHEEZING• SHORTNESS OF BREATH
![Page 13: CLINICAL FEATURES OF RIGHT COLONIC CANCER](https://reader035.fdocuments.net/reader035/viewer/2022062900/58ecdef71a28ab4d4b8b46df/html5/thumbnails/13.jpg)
BONE METASTASIS• BONE PAIN• MUSCLE WEAKNESS AND NUMBNESS• WEAK BONES WITH INCREASED
SUSCEPTIBILITY TO FRACTURE• INCREASED SERUM CALCIUM LEVEL• BONE MARROW SUPPRESSION
![Page 14: CLINICAL FEATURES OF RIGHT COLONIC CANCER](https://reader035.fdocuments.net/reader035/viewer/2022062900/58ecdef71a28ab4d4b8b46df/html5/thumbnails/14.jpg)
MODIFIED DUKE’S CLASSIFICATION
A : GROWTH LIMITED TO BOWEL WALL B : INVADES INTO EXTRABOWEL TISSUES
BUT NO LYMPH NODES ARE INVOLVED B1 : INVADING MUSCULARIS PROPRIA B2 : INVADING INTO OR THROUGH
SEROSA C : LYMPH NODE SECONDARIES D : DISTANT SPREAD