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Obstructing colon cancer presenting as toxic megacolon


Gastroenterology & Hepatology: Open Access
Sánchez Hernández Rodrigo, Carbó Romano Rafael, Weber Sánchez Alejandro

Abstract

Introduction: Colon cancer is the most frequent cause of colonic obstruction which is usually manifested by distention, bloating, and pain. Colonic obstruction with a competent ileocecal valve is a risk factor for complications such as ischemia, necrosis, perforation, but toxic megacolon is seldom mentioned in literature.

Case report: This case describes a patient with left sided colon cancer presenting initially with obstructive symptoms that developed into a serious toxic megacolon within a few hours. Emergent surgery was performed. Descending and transverse colon were 20cm in diameter so left sided hemicolectomy was performed with end colostomy. In our literature review, several references mention that cancer is a potential cause of toxic megacolon, but with no reported source to state this. A PubMed search did not offer any results for toxic megacolon associated to cancer when C. difficile or colitis were excluded.

Conclusion: Colon cancer is not usually associated with toxic megacolon. Making a late decision to perform urgent surgery increase the rate of complications and worse prognosis.

Keywords

toxic megacolon, colon cancer, laparoscopy, chemotherapy

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