Wednesday, October 15, 2014

CARCOINOMA COLON RECTUM 3 Clinical menifestation,Diagnosis


CLINICAL MANIFESTATIONS

The  clinical presentation is of abrupt onset in about  one-third
and may run a fulminant course in 10%.

*  Persistent  diarrhoea, preceded by lower abdominal  cramps  is
   the usual complaint.

*  Small stools recurring 20 to 30 times per day.

The diarrhoea produces

*  Dehydration
*  Hypokalemia
*  Anaemia
*  Hypoproteinemia
*  Marked weight loss
*  Relapsing  form with remissions is also  common.   Recurrences
   are  associated  with  emotional  stress,  physical   fatigue,
   respiratory infections and other acute illness.
*  Lower abdominal cramping is always present.

COMPLICATIONS

*  Electrolyte deficiencies
*  Microcytic anaemia
*  Arthritis
*  Arthralgias
*  Spondylitis

Colonic complications include gross haemorrhage

*  Stricture formation
*  Partial obstruction
*  Perforation may occur in the course of the disease

LATE COMPLICATIONS

Late complications also include toxic megacolon and carcinoma  of
the colon.

DIAGNOSIS

Colonoscopy Sigmodoscopy  including  rectal  biopsy  and  Barium  enema   are
important in arriving at a diagnosis (Fig. 19.2).

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