scholarly journals Surgical outcome and clinical profile of emergency versus elective cases of colorectal cancer in College of Medical Sciences, Nepal

2014 ◽  
Vol 9 (2) ◽  
pp. 25-30 ◽  
Author(s):  
Sujit Kumar ◽  
P Kafle ◽  
BN Patowary ◽  
N Belbase ◽  
S Agrawal ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Intestinal Obstruction ◽  
Rectal Bleeding ◽  
Surgical Outcome ◽  
Clinical Presentation ◽  
Morbidity And Mortality ◽  
Colorectal Cancers ◽  
Medical Sciences ◽  
Female Ratio ◽  
Left Hemicolectomy

Background: Patients who undergo emergency colorectal cancer surgery has poor outcome compared to elective surgery, both in terms of morbidity and mortality. Approximately 15 to 30% of colorectal cancers present as an emergency, most often as obstruction or perforation. Objective: To compare surgical outcome and clinical profiles of emergency and elective cases for colorectal cancer. Methods: Retrospective analysis of 34 cases who underwent surgery for colorectal cancer between December 2011 to January 2013was carried out and their surgical outcomes, clinical presentation, demographic profile were analyzed. Results: The total numbers of patients included in this study were 34. Out of which 52.94 %( n=18) were emergency cases and 47.05 %( n=16) were elective. Male female ratio was 3:1 in emergency cases and 2.6:1 in elective cases. Per rectal bleeding (56%) and altered bowel habit (31.25%) was predominant clinical presentation in elective cases whereas intestinal obstruction (55.55%) and peritonitis (22.22%) were predominant clinical presentation in emergency cases. In emergency cases most of the tumors were located in left side (77.77%) and in elective cases rectum was common site (37.5%). Left hemicolectomy was the commonest surgery performed (72.22%) in emergency set up. In elective cases, right hemicolectomy, left hemicolectomy, APR and LAR was done in 31.25%, 31.25%, 25% and 25% cases respectively. In the emergency group 11.11% (n=2) developed enterocutaneous fistula and early mortality within 30 days was observed in 5% (n=1) of emergency cases only. Conclusion: In emergency conditions, colorectal cancer presented with intestinal obstruction where as elective cases presented with per rectal bleeding and altered bowel habits. Compared with the elective patients, the emergency patients had higher rate of morbidity and mortality. Because of higher incidence of colorectal cancer in our institution, in all emergency cases who presents with features of intestinal obstruction and peritonitis, we have to rule out colorectal cancer especially if the patients are elderly. Therefore, we should encourage screening programme for early detection of colorectal cancers for better outcome of surgery. Journal of College of Medical Sciences-Nepal, 2013, Vol-9, No-2, 25-30 DOI: http://dx.doi.org/10.3126/jcmsn.v9i2.9684

High incidence of advanced stage cancer and prolonged rectal bleeding history before diagnosis in young-onset patients with colorectal cancer.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. 3576-3576
Author(s):  
Gurprataap Singh Sandhu ◽  
Rebekah Anders ◽  
Amy Walde ◽  
Alexis Diane Leal ◽  
Gentry Teng King ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Rectal Cancer ◽  
Family History ◽  
Rectal Bleeding ◽  
Clinical Presentation ◽  
Advanced Disease ◽  
Younger Patients ◽  
Young Onset ◽  
The Mean ◽  
Bleeding History

3576 Background: In contrast to the older population, the incidence of colorectal cancer (CRC) in younger patients (aged < 50 years) has been increasing in the last three decades. Younger patients tend to present with more advanced disease, thought to be in part related to lack of routine screening colonoscopies. The goal of this study was to examine characteristics of young-onset CRC and potentially identify factors that may aid in earlier diagnosis and treatment. Methods: We collected data for patients available through the University of Colorado Cancer Center Cancer Registry. Inclusion criteria included: 1) Diagnosis of colon or rectal cancer between the years 2012-2018 and 2) age at diagnosis of less than 50 years. Pertinent data including baseline characteristics, clinical presentation, family history, pathology, molecular testing, staging, and treatment were collected. Results: 211 patients with young-onset CRC were available for review. Mean age at diagnosis was 42.4 years and 55.5% were males. A total of 42.1% had rectal cancer and a majority of the colon cancer diagnoses had left-sided tumors (66%). Regarding clinical presentation, 52.2% presented with rectal bleeding prior to diagnosis. Of those who presented with rectal bleeding, the average time from the onset of bleeding to diagnosis was 271.17 days. 42.9% of young-onset CRC were stage IV at the time of initial diagnosis. Evaluation of the pathology specimens showed that 89.6% were adenocarcinomas and 63.5% were grade 2 or higher. At diagnosis, the mean BMI was 26.6 and the mean CEA was 135.5. A total of 72.5% of young-onset patients had a positive family history of any cancer. KRAS or NRAS mutations were present in 49.6% of patients, BRAF V600E mutations were present in 3.8%, and 10.8% were MSI-H. Conclusions: Prolonged rectal bleeding history prior to diagnosis was noted in a significant proportion of young-onset patients with colorectal cancer. Patients and primary care physicians should be made aware of this finding in order to facilitate timely referral for colonoscopy which may lead to earlier diagnosis, less advanced disease at diagnosis, and improved outcomes.

scholarly journals STUDY OF CLINICAL PROFILE OF PATIENTS WITH COLORECTAL CANCER

2020 ◽  
pp. 1-2
Author(s):  
MS Revathy ◽  
Monali Nistane ◽  
Manimaran M ◽  
Sumati B
Keyword(s):  
Colorectal Cancer ◽  
Risk Factors ◽  
Risk Factor ◽  
Rectal Bleeding ◽  
Clinical Profile ◽  
Common Symptom ◽  
Newly Diagnosed ◽  
Common Risk Factor ◽  
Female Ratio ◽  
Fiber Diet

Background: Colorectal cancer (CRC) incidence and mortality rates vary markedly around the world with low reported cases in India. It is a lethal disease with high mortality. It has varied presentation from asymptomatic, anaemia, altered bowel habits to frank bleeding per rectum, intestinal obstruction. There are very few studies in India describing the clinical profile and risk factors of CRC. Objective: To study Clinical profile and risk factors in patients with colorectal cancer. Methods: A prospective single center study was conducted from August 2018 to August 2019. It included all patients who were newly diagnosed CRC. Their demographic profile, site of lesion, clinical presentations, risk factors, colonoscopic findings, histology of the lesion, biochemical analysis and imaging were performed. Results: 32 patients with newly diagnosed CRC were evaluated. Mean age was 52.4 years. Male to female ratio was 1.5:1. Overall fatigue was the most common symptom (87.5%) followed by per rectal bleeding (37.5%). Fatigue was the most common symptom with right sided CRC while per rectal bleeding was the most common symptom with rectal CRC. Low fiber diet was most common risk factor (71.9%). Histologically adenocarcinoma was the most common type (90.6%). Conclusion: Rectum was the most common site and adenocarcinoma was the most common histological type. Low fiber diet was the most common risk factor. Majority of the patients had localized or locally advanced disease observed in our study.

scholarly journals Clinical, Surgical and Outcome Predictive Factor Analysis of Operated Acute Subdural Hematoma Cases: A Retrospective Study of 114 Operated Cases at Tertiary Centre

2021 ◽  
Author(s):  
Rahul Singh ◽  
Ravi Shankar Prasad ◽  
Kulwant Singh ◽  
Anurag Sahu ◽  
Nityanand Pandey
Keyword(s):  
Retrospective Study ◽  
Subdural Hematoma ◽  
Surgical Outcome ◽  
Motor Response ◽  
Clinical Presentation ◽  
Tertiary Care ◽  
Acute Subdural Hematoma ◽  
Age Group ◽  
Female Ratio ◽  
Severity Of Injury

Abstract Objective To analyze clinical, surgical and outcome predictive factors of operated acute subdural hematoma (SDH) cases for prognostication and surgical outcome prediction. Material and Methods This retrospective study includes 114 patients operated for acute SDH in the Department of Neurosurgery of IMS BHU, Varanasi, India, a tertiary care center, between 1 August 2018 and 1 November 2019. Each patient was evaluated for age, sex, mode of injury, localization of hematoma, clinical presentation, comorbidity, severity of injury, best motor response, CT findings, and Glasgow outcome scale (GOS) at discharge. The outcome was also evaluated by further making a dichotomized group using GOS in death/dependent (1–3) versus independent (4–5). Statistical tests were done using the GraphPad Prism version 8.3.0. Results The most common age group operated upon in this study was the 40 to 60 years age group (n = 45, 39.48%). Males were 78% with male to female ratio of 3.56:1. The most common clinical presentation was altered sensorium (98.25%). The most common comorbidity was hypertension (n = 32, 28.07%). GCS at admission, severity of injury, pupillary changes, and best motor response (p < 0.0001) were significantly associated with surgical outcome. Conclusion GCS at admission, severity of injury, pupillary changes, and best motor response were significantly (p < 0.05) associated with surgical outcome. Age and gender of patients were not found to be significantly associated.

scholarly journals HELLP syndrome against the background of glomerulonephritis: Clinical casereport

2019 ◽  
pp. 27-30
Author(s):  
L. Lebid ◽  
L. Snisar ◽  
L. Liksunova
Keyword(s):  
Hellp Syndrome ◽  
Laboratory Tests ◽  
Clinical Presentation ◽  
Liver Enzymes ◽  
Morbidity And Mortality ◽  
Chronic Glomerulonephritis ◽  
Medical Sciences ◽  
Severe Morbidity ◽  
Elevated Liver Enzymes

 HELLP syndrome (hemolysis, elevated liver enzymes, and low platelets) is a severe and rapidly progressing condition that requires distinct diagnostic considerations. The clinical presentation varied within all of the classes, and the only objective means of diagnosis and evaluation of progression of the condition are laboratory tests. HELLP syndrome may result in severe morbidity and mortality to both the mother and fetus. In this case, we reported that a patient with chronic glomerulonephritis was diagnosed with HELLP syndrome.The case was collected in Institute of Nephrology of the National Academy of Medical Sciences, Kyiv, Ukraine.

A CLINICAL STUDY ON VARIOUS PRESENTATION AND MANAGEMENT OF ACUTE INTESTINAL OBSTRUCTION

2021 ◽  
pp. 69-73
Author(s):  
Mohit Birla ◽  
Heeralal Jakhar ◽  
Amit Bagra ◽  
Siddhartha Verma
Keyword(s):  
Small Bowel ◽  
Intestinal Obstruction ◽  
Bowel Obstruction ◽  
Large Bowel ◽  
Acute Intestinal Obstruction ◽  
Morbidity And Mortality ◽  
Abdominal Hernia ◽  
Medical Illness ◽  
Female Ratio ◽  
Study Results

BACKGROUND: The diagnosis and management of patient with intestinal obstruction is one of the more challenging emergency that a general surgeon can come across. With better understanding of pathophysiology, improvement in diagnostic techniques, uid and electrolyte correction, much potent antibiotics and surgical management the complications arising due to late presentation can be limited. AIMS AND OBJECTIVES: To analyze different modes of presentation, various etiological factors of acute intestinal obstruction and to evaluate the different lines of management and its outcome. METHDOLOGY: This study was conducted in M.B Government Hospital attached to R.N.T. Medical College Udaipur. 50 patients fullling the inclusion criteria were part of this study. RESULTS: Intestinal obstruction is more common in the age group of 41-50 years. Male to female ratio is 2.6:1. Small bowel obstruction is more common than large bowel obstruction. Four cardinal features of intestinal obstruction are pain abdomen, vomiting, distension and constipation. Most common etiological factor is postoperative adhesions followed by abdominal hernia. Malignancy as a cause for obstruction is more common in large bowel than small bowel. Most patients were treated by operative procedure in comparison to conservative management; adhesiolysis (14 cases) was carried out commonly. CONCLUSION: Obstruction due to adhesions is increasing in incidence due to increased abdominal & pelvic surgeries. The obstruction due to external hernias is decreasing due to early elective surgeries. The morbidity and mortality depends on the age of the patient, etiology of obstruction, site of obstruction, state of hydration, viability of the bowel, delay in diagnosis and surgical intervention and associated medical illness. Early diagnosis of possible strangulation will markedly decrease morbidity and mortality.

scholarly journals Clinical presentation of ulcerative colitis among Bangladeshi population twenty years experience from a tertiary care hospital in Bangladesh

2016 ◽  
Vol 6 (1) ◽  
pp. 16
Author(s):  
Mohammad Shoaib Chowdhury ◽  
Md. Masudur Rahman Khan ◽  
Md. Zahidur Rahman ◽  
Madhusudan Saha ◽  
Guru Prashad Dhakal ◽  
...  
Keyword(s):  
Ulcerative Colitis ◽  
Weight Loss ◽  
Rectal Bleeding ◽  
Clinical Presentation ◽  
Age Group ◽  
Female Ratio ◽  
Female Patients ◽  
Male Female Ratio ◽  
Male Patients ◽  
Bangladeshi Population

<p><strong>Background:</strong> The prevalence of Ulcerative colitis has been increasingly reported from Western countries as well as other Asian countries. Our personal experience shows that Ulcerative colitis is not uncommon in our country and is being diagnosed more commonly. So, there is need to study the disease pattern in our country. Objective: To find out the clinical presentation, among Bangladeshi population. <strong></strong></p><p><strong>Methods:</strong> A hospital (Department of Gastroenterology, Bang­abandhu Sheikh Mujib Medical University) based study registering previously diagnosed and newly diagnosed cases of Ulcerative colitis, was carried out from January 1990 to June 2010. Data that were obtained are: age and sex of the patients, clinical presentations like bloody diarrhoea, per rectal bleeding, diarrhoea without per rectal bleeding, urgency, tenesmus, abdominal pain, fever, anorexia, weakness, weight loss. Data regarding physical findings and extra intestinal manifestations were also recorded. <strong></strong></p><p><strong>Results:</strong> Out of 164 patients 65.24% (107) were male and 34.76% (57) were female. The male- female ratio was 1.88 : 1. Mean age of male patients was 36.14(±11.66) years and mean age for female patients was 33.15(±11.12) years. Maximum number of male patients were in 21-40 years age group (65.42%, 70). Maximum number of female patients were in 21-30 years age group (42.10%, 24). Maximum number of both male and female patients were in 21-30 years age group (35.97%, 59). Clinical features of 164 patients showed that 87.28% (143) had bloody diarrhoea, 20.12% (33) had per-rectal bleeding, 4.26% (7) had diarrhoea without per rectal bleeding, 1.21% (2) had urgency, 5.48% (9) had tenesmus, 33.53% (55) had abdominal pain, 17.66% (29) had fever, 18.29% (30) had anorexia, weakness and 17.68% (29) had weight loss at their initial presentation. Physical examination of 164 patients revealed that 81(49.39%) patients had normal findings, 7 (4.27%) patients had oedema and 83 (50.61%) patients had anaemia. Extra intestinal features were absent in 143 (87.20%) patients out of 164 patients. The rest 21 (12.80%) patients had joint involvement and 2 ( 1.21 % ) patients had ocular involvement. There was no patient with skin involvement. <strong></strong></p><p><strong>Conclusion:</strong> The clinical presentation of Ulcerative colitis in our country is mostly similar compared to other Asian' and Western countries except higher male-female ratio, presence of oedema and wide variability of extra intestinal involve­ment. These differences are probably due to social and cultural reasons, poor nutritional status, incomplete workup or records and influence of various enviornmental factors. To validate these results further prospective studies are needed.</p>

scholarly journals Clinicopathological profile of colorectal carcinoma in a tertiary care teaching hospital in Pokhara, Nepal

2021 ◽  
Vol 14 (1) ◽  
pp. 14-18
Author(s):  
Subash Bhattarai ◽  
Om Bahadur Karki ◽  
Merina Gyawali ◽  
Sudeep Regmi
Keyword(s):  
Colorectal Cancer ◽  
Weight Loss ◽  
Abdominal Pain ◽  
Colorectal Carcinoma ◽  
Rectal Bleeding ◽  
Clinical Presentation ◽  
Chronic Abdominal Pain ◽  
Screening Colonoscopy ◽  
Presenting Symptoms ◽  
Bowel Habits

Introduction: Colorectal cancer is the most common malignancy of the gastrointestinal tract. They are common after 50 years of age and present with bleeding per rectum, altered bowel habits, anemia, pain abdomen, and weight loss. The objective of this study was to evaluate the demographic profile, clinical presentation, colonoscopy and histopathology findings of colorectal cancer. Methods: A descriptive cross-sectional study was conducted. Cases were studied from the departmental records. Clinical presentation, CT abdomen, colonoscopy, and histopathology findings of colorectal carcinoma were studied. Data entry was done in SPSS version 20. Results: The mean age of subjects was 56 ± 11.42 years (range of 34 – 80 years) with male predominance (M: F=3:2). Changes in bowel habits (92.3%), chronic abdominal pain (84.6%), generalized weakness (80.7%), rectal bleeding (46.2%), and significant weight loss (42.3%) were the most common presenting symptoms. Rectal carcinoma was the most common (35%) followed by carcinomas of ascending colon (14%) and descending colon (10 %). The most common morphology was proliferative growth (61.5%). All colorectal carcinomas were adenocarcinoma, and the majority was moderately differentiated (51.9%). Conclusion: Colorectal cancers are seen above 50 years of age and common in males. Changes in bowel habits, chronic abdominal pain, generalized weakness, rectal bleeding, and weight loss are the most common form of presentations. These patients usually present late with advanced disease and unfavorable histopathology. Screening colonoscopy >50 years is strongly recommended.

Comparison of Co-Presence of Epstein-Barr Virus and High-Risk Human Papillomaviruses in Colorectal Cancers in the Middle East Region

2020 ◽  
Author(s):  
Karim Nagi ◽  
Ishita Gupta ◽  
Hamda A Al-Thawadi ◽  
Ayesha Jabeen ◽  
Mohammed I. Malk ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
High Risk ◽  
Epstein Barr Virus ◽  
Human Papillomaviruses ◽  
Colorectal Cancers ◽  
Barr Virus ◽  
Human Carcinomas ◽  
Epstein Barr ◽  
Invasive Carcinomas ◽  
High Risk Hpv

Background: Several studies have shown the presence of onco viral DNA in colorectal tumor tissues. Viral infection by onco-viruses such as Human papillomaviruses (HPVs) and Epstein–Barr virus (EBV) are well-known to be involved in the onset and/or progression of numerous human carcinomas. Methods: We explored the co-presence of high-risk HPVs and EBV in a cohort of colorectal cancer samples from Lebanon (94) and Syria (102) by PCR, immunohistochemistry and tissue microarray. Results: The results of the study point out that 54% of colorectal cancer cases in Syria are positive for high-risk HPVs, while 30% of the cases in Lebanon are positive for these viruses; the most frequent high-risk HPV types in these populations are 16, 18, 31, 33 and 35. Analysis of LMP1 showed similar results in both populations; 36% of Syrian and 31% of Lebanese samples. Additionally, we report that EBV and high-risk HPVs are co-present in these samples. In Syrian samples, EBV and HPVs are co-present in 16% of the population, however, in the Lebanese samples, 20% of the cases are positive for both EBV and HPVs; their co-presence is associated with high/intermediate grade invasive carcinomas. Conclusion: These data suggest that EBV and high-risk HPVs are co-present in human colorectal cancers where they can cooperate in the progression of these cancers. Nevertheless, further studies are needed to elucidate the role of those oncoviruses in the development of human colorectal carcinomas.

CLINICAL, ENDOSCOPIC AND PATHOGICAL CHARACTERISTICS OF COLORECTAL CANCER AT DA NANG HOSPITAL FROM 2016 TO 2017

2018 ◽  
pp. 9-14
Author(s):  
Thanh Trung Nguyen ◽  
Duc Nhan Le ◽  
Van Xung Nguyen ◽  
Hieu Trung Doan
Keyword(s):  
Colorectal Cancer ◽  
Descriptive Study ◽  
Bloody Stool ◽  
Key Words Colorectal Cancer ◽  
Right Colon ◽  
Female Ratio ◽  
Histopathological Classification ◽  
Male Female Ratio ◽  
Female Male Female ◽  
Colorectal Cancer Patients

Objective: To study the clinical, endoscopy and pathogical characteristics of colorectal cancer at Da Nang Hospital. Methods: A retrospectively descriptive study, performed from 01/01/2016 to 31/12/2017 at Da Nang Hospital. Results: During two years, there were 205 cases of colorectal cancer patients hospitalized to Da Nang Hospital. Male: 59.51%, female: 40.49%, mean age: 65.8 ± 16.07. Male is higher than female, male/ female ratio is 1.4/1. The period from the first symptoms to admission < 3months predominated (83.8%). The predominant symptoms: Abdominal pain (85.85%), bloody stool (63.41%), defecation (62.44%), anemia (34.63%), weight loss (25.85%), fatigue (17.56%), abdominal distention (12.19%), nausea and vomiting (5.36%). Location of Lesions: Rectum (43.42%), sigmoid colon (20%), right colon (10.73%),cecum (10.73%), transverse colon (7.80%), left-colon (7.32%). Type of lesion on endoscopy: Exophytic (63.41%), ulceration-Exophytic (21.95%), ulceration (7.32%), polyp chemotherapy (7.32). Tumor size: ≥ 3/4 perimeter (39%), occupying the whole circumference (37.0%), occupying ≥ 1/2 perimeter (15.6%), accounting for 1/4 Perimeter (8.4%). The colon completely narrowed rate: 70.73%., incompletely was 29.27%. Histopathological classification: adenocarcinoma (85.85%), Mucinous adenocarcinoma: (9.27%) and non-differentiated epithelial carcinoma was 4.88%. Conclusion: Colorectal cancer was quite popular and was usually detected at advanced stages.Therefore, screening for subjects with risk factors for early detection and treatment is recommended. Key words: Colorectal cancer, endoscopy, pathogical characteristics...

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