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3 slides ca colon

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3 slides ca colon 3 slides ca colon Presentation Transcript

  • Examen Preliminar1. El sitio del Colon donde con mayor frecuencia se encuentra el Cáncer es a) Rectosigmoides b) Transverso c) Ascendente d) Descendente e) Ciego
  • 2. Menciona cual de las enfermedades abajo mencionadas se relaciona con el desarrollo de Cáncer de Colon a) Colitis Amibiana b) Colitis Pseudomembranosa c) Enfermedad de Hirsprung d) Colon Redundante e) Colitis Ulcerosa Cronica Inespecifica
  • 3. Si se localiza en Ciego , un dato clinico que se reporta es: a) Sangrado b) Datos de Obstrucción Intestinal c) Masa Palpable d) Ictericia e) Diarrea
  • 4. Un método actual para evaluación de diseminación local del Cáncer colórectal es: a) Colonoscopia b) Colon por Enema con Bario c) Colonoscopia virtual d) Endosonografia e) Placas simples de abdomen
  • 5 . La Poliposis que se asocia a polipos Gástricos y Deformaciones en macizo facial asi como osteomas es a) Síndrome de Turkot b) Síndrome de Poliposis Familiar Múltiple c) Síndrome de Gardner d) Síndrome de Peutz Jegehrz e) Síndrome de Cronkite-Canada
  • Cancer de Colon Dr. Armando Téllez Hernández Universidad de MonterreyServicios Medicos de la Seccion 50 Monterrey, N. L.
  • HOMBRES
  • MUJERES
  • Incidencia de Cáncer de Colon en 2004 en USA• DIAGNOSTICO 70 651 EN Hombres 68 883 En mujeres• MORTALIDAD 28 471 Hombres 28 132 Mujeres
  • Pronostico• 1.6 Serán diagnosticados en 2006• 56 500 Morirán por dicho problema---------------------------------------------------------- 106 680 Nuevos casos 41 930 Morirán de Cáncer de Recto 55 170 De Cáncer Colorectal Soc Amen Cir Colorectal
  • Factores de Riesgo• Historia Familiar de Cáncer• Antecedente de Síndromes de Poliposis• Antecedente de Resección Previa de Ca de colon• Raza• Enfermedad Inflamatoria Intestinal• Edad• Escaso Ejercicio• Dieta alta en grasa• Sobrepeso• Tabaquismo• Etilismo
  • Angle 11 % Angle 2% 2% 18 % 20 % Sigmoid ColonCecum 15 % 7% Rectum 25 %
  • Carcinoma de Colon Diagnostico clínico Ascendente Transverso RectosigmoidesAstenia /Hipodinamia +++ +++ +++Baja de Peso +++ +++ +++Masa Palpable +++ ++ ++Obstruccion + + +++Sangrado +++ + ++Distension + + +++Dolor + + ++Diarrea ++ + ++Estreñimiento - + ++Heces acintadas - - ++Tacto rectal positivo - - +++
  • DIAGNOSTICO• CLINICO• RADIOLOGICO• TAC• SIGMOIDOSCOPIA• COLONOSCOPIA / BIOPSIA• COLOSCOPIA VIRTUAL• ECOGRAFIA• ENDOSONOGRAFIA• RESONANCIA
  • COLONOSCOPIA VIRTUAL
  • SIGMOIDOSCOPIA FLEXIBLE
  • ENDOSONOGRFIA
  • CANCER COLORECTAL
  • Clasificación del Cáncer de ColonEtapa 0 o (carcinoma in). Solo en tejidos superficiales del colon.Etapa I. Células rebasa la capa submucosa la muscular de la mucosa y la pared muscular interna del colon no la capa muscular externa ( Dukes A).Etapa II. Afecta la pared externa, pero no a los ganglios linfáticos. (Dukes B).Etapa III. Invade capas externas del colon y ganglios linfáticos vecinos, pero no a otros órganos (Dukes C).Etapa IV Invade otros órganos del cuerpo (Dukes D).Recurrente. Cuando vuelven a parecer células una vez recibido tratamiento, pueden aparecer en el colon o a otra parte del cuerpo (hígado, pulmones)
  • Cancer de Colon Recomendaciones de Screening• Prueba de Sangre Oculta en Heces cada año• Sigmoidoscopia Flexible cada 5 años• Colon Por Enema cada 5 años• Colonoscopia cada 10 años
  • American Cancer Society Guidelines on Screening and Surveillance for the Early Detection of Colorectal Adenomas and Cancer -- Women and Men at Increased Risk or at High RiskRisk Category Age to Begin Recommendation CommentsINCREASED RISKPeople with a single, small 3-6 years after the initial Colonoscopy1 If the exam is normal, the patient(< 1 cm) adenoma polypectomy can thereafter be screened as per average risk guidelines.People with a large (1 cm +) Within 3 years after the initial Colonoscopy1 If normal, repeat examination in 3adenoma, multiple adenomas, polypectomy years; If normal then, the patientor adenomas with high-grade can thereafter be screened asdysplasia or villous change. per average risk guidelines.Personal history of curative Within 1 year after cancer resectio Colonoscopy1 If normal, repeat examination in 3intent resection of colorectal years; If normal then, repeatcancer examination every 5 years.Either colorectal cancer or Age 40, or 10 years before the Colonoscopy1 Every 5-10 years. Colorectaladenomatous polyps, in any youngest case in the immediate cancer in relatives more distantfirst-degree relative before age family, whichever is earlier than first-degree does not60, or in two or more first increase risk substantially abovedegree relatives at any age (if the average risk groupnot a hereditary syndrome).
  • American Cancer Society Guidelines on Screening and Surveillance for the Early Detection of Colorectal Adenomas and Cancer -- Women and Men at Increased Risk or at High RiskHIGH RISKFamily history of familial Puberty Early surveillance with If the genetic test is positive,adenomatous polyposis (FAP) endoscopy, and counseling to colectomy is indicated. These consider genetic testing patients are best referred to a center with experience in the management of FAP.Family history of hereditary non Age 21 Colonoscopy and counseling to If the genetic test is positive or ifpolyposis colon cancer (HNPCC) consider genetic testing the patient has not had genetic testing, every 1-2 years until age 40, then annually. These patients are best referred to a center with experience in the management of HNPCC.Inflammatory bowel disease Cancer risk begins to Colonoscopy with biopsies for Every 1-2 years. These patientsChronic ulcerative colitis Crohns besignificant 8 years after the dysplasia are best referred to a center withdisease onset of pancolitis, or 12-15 experience in the surveillance years after the onset of left-sided and management of inflammatory colitis bowel disease