This preparetion was prepared for Prof. Feroze Quder on the eve of 21st Feb for a class for the undergraduate medical students.

2. Prof. Feroze Quader Dept. of Surgery Begum Khaleda Zia Medical College

5. Peutz-Jegher’s syndrome

7. Tubular Adenoma Villous

10. Symptomatic patients: Loose stool Lower abdominal pain Weight loss Diarrhoea Passage of blood &Mucus. Asymptomatic patients: Usually are diagnosed during screening or incidentally. Clinical features

12. Some extra-cortical manifestations Benign Endocrine adenome Osteoma Epidermoid cyst Hypertrophic retinal pigmentation Medulloblastoma Malignant Duodenal carcinoma Desmoid tumor Bile duct, pancreatic carcinoma Carcinoma stomach

18. Pathology Microscopically The neoplasm is a columnar cell Carcinoma originating in the colonic epithelium. Macroscopically The tumor may take one of four forms . Type 4 is the least malignant form.

19. Pathology Types of growth

21. Staging Dukes’ classification A Confined to bowel wall. B Through the bowel wall but not involving the free Peritoneal serosal surface . C Lymph nodes involved. D advanced local disease or metastasis to liver.

22. CARCINOMA COLON Clinical Feature Carcinoma of the left side of the colon: Pain Alteration of bowel habit Palpable lump Distension

23. CARCINOMA COLON Clinical Feature… Carcinoma of the sigmoid: Pain Tenesmus Bladder symptoms

24. CARCINOMA COLON Clinical Feature Carcinoma of the transverse colon: Palpable lump Anaemia Lassitude

25. CARCINOMA COLON Clinical Feature Carcinoma of the caecum and ascending colon: Anemia Lump in right iliac fossa Acute appendicitis Intermittent obstruction

27. CARCINOMA COLON Investigations Diagnostic: Endoscopy Sigmoidescopy Colonscopy With tissue biopsy

28. Investigations Radiology Double contrast barium enema Shows Irregular filling defect Ultra-sonography Liver metastasis CT Scan Local invasion specially in Pelvis