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Patient with abdominal pain, alternating diarrhea and constipation, without any visible blood, slight weight loss, and fatigue for three weeks. (General surgery)

Dr. Adnan A Al Aloul., SECONDARY SCHOOL, GENERAL MEDICINE, GENERAL SURGERY, FAMILY MEDICINE, ECHIVALATION GENERAL SURGERY, GENERAL ULTRASOUND, ENDOSCOPY

 

Medical Case Details:

A 74 year old female patient with no prior medical illness presents to a general practitioner with abdominal pain, alternating diarrhea and constipation, without any visible blood, slight weight loss (3 kg in two months), good appetite, and fatigue in the last two to three weeks.

Clinically, the patient is in a good condition, the body mass index is at 29, abdomen: soft and lax, fatty, PR: normal.

On investigation, lab tests showed mild iron deficiency anemia (10 g/dL), U/S: WNL, colonoscopy: showed a vegetative tumor, slight bleeding at 90 cm of anocutaneous line, biopsy was taken and pathology report: Adenocarcinoma. CT scan of thoracic, and abdomen: distant metastasis was ruled out.

The segmental colectomy is planned for next week.

 


    Discussions


    Dr. Ajit
    General Surgeon

    Yes .the treatment planned is correct.U may order tumour marker pre op such as CEA and CA19-9 .this helps post op to detect recurrence.Pt may require chemotherapy post resection depending on the histopathology report.

    Best comment
    18.Nov, 12:28pm

    Dr. Alp Gurkan
    Nephrologist

    The treatment plan is correct. Depends on pathology, the patient may require chemotherapy

    Best comment
    18.Nov, 04:37pm

    Dr. Adnan A Al Aloul
    General Surgeon

    Yes.... the tumour markers were normal.
    It are important for follow up for the recurrence
    On next moday i will see intraoperative findings and then after 3 weeks the result of histopathology.

    18.Nov, 10:19pm

    Dr. Adnan A Al Aloul
    General Surgeon

    The pacient operated today:
    Intraoperative findings: tumor in the transvese colon in the midle part looks malignant tumor with lymph nodes involvement macroscopicaly 3 LN, in the mezocolon, no local metastasis no liver or intraabdominal metastasis by inspection or palpation.
    The procedure was segmental transverse colectomy with primary anastomosis (with safty margini), i left 2 tubes drain one subhepatic near the anastomosis and another in the pelvis
    The piece was sent to hitopathology.
    She is well, extubated, with O2 3%
    I hope to be ok.

    22.Nov, 12:52am

    Dr. Potnuru Srinivaasa Sudhakar
    Homeopathic Physician

    Dear Doctor if allow me i will suggest some homeopathic approach for Adeno carcinoma with loss of weight.
    Homeopathy can be used as supportive treatment.
    To prevent further complications and pain and for palliation Homeopathhy can help the patient.
    According to your report there is no evidence of metastasis, it is better to try Homeopathy.
    If pain present Calcaria.Carb 30 helps to reduce pain.
    Ferrum.Phos also helps to produce blood cells to reduce anemia.
    For alternate constipation and diarrhea Nux vom 30 helpful.
    Dear doctor respond me if you like to fallow the Homeopathic type of treatment.
    Thank you doctor.

    29.Nov, 06:41pm



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