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CLINICAL FEATURES OF RIGHT COLONIC CANCER
This document summarizes the clinical presentation of colon cancer in three main ways: vague abdominal symptoms and pallor, asymptomatic individuals found through screening, and emergency conditions involving intestinal obstruction, peritonitis, or bleeding. It then describes symptoms according to anatomical site of the cancer in the colon. Advanced cancer may present with abdominal pain, distension, vomiting, constipation, and signs of dehydration or metastasis. Complications include stercoral ulcer, obstruction, perforation, and peritonitis. The cancer can spread locally, hematogenously, or lymphatically to sites like the liver, lungs, bones, and more. A modified Duke's classification stages colon cancers from A to D.
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CLINICAL FEATURES OF RIGHT COLONIC CANCER
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- 2. CLINICAL PRESENTATION Patients withCOLON CANCER present in three ways- VAGUE ABDOMINAL SYMPTOMS AND PALLOR ASYMPTOMATIC INDIVIDUALS DISCOVERED BY ROUTINE SCREENING EMERGENCY CONDITION WITH INTESTINAL OBSTRUCTION,PERITONITIS OR RARELY ACUTE GI BLEDDING
- 3. CLINICAL PRESENTATION ACCORDING TOANATOMICAL SITE RIGHT SIDED COLONIC CANCER FATIGUE ASSOCIATED WITH ANAEMIA ALTERED BOWEL HABIT ABDOMINAL PAIN IN ADVANCED TUMORS MELENA-DARK TARRY STOOL RIGHT SIDED ABDOMINAL MASS
- 5. DESCENDING / SIGMOID COLON: CONSTIPATIONALTERNATING WITH DIARRHOEA,ABDOMINAL PAIN AND OBSTRUCTIVE SYMPTOMS,MELENA, PERFORATION TRANSVERSE: ALTERED BOWEL HABITS,BOWEL OBSTRUCTION,MELENA RECTAL: CHANGES IN BOWEL MOVEMENT,RECTAL FULLNESS,URGENCY,BLEEDING, TENESMUS ANAL: BLEEDING,DISCHARGE,MASS, TENDERNESS ON PALPATION,PAIN ON DEFECATION
- 6. ADVANCED CANCER PAINABDOMEN-COLICKY AND RECURRENT DISTENSION,VOMITTING CONSTIPATION REDUCED BOWEL SOUNDS ON AUSCULTATION DEHYDRATION,TACHYCARDIA, HYPOTENSION PALPABLE LEFT SUPRACLAVICULAR LYMPH NODES(VIRCHOW’S NODE) METASTATIC FEATURES
- 7. COMPLICATIONS STERCORAL ULCER OBSTRUCTION PERFORATION PERITONITIS PERICOLIC ABSCESS
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- 9. LOCAL SPREAD INVADE THE BLADDER,OBSTRUCT URETERCAUSING HYDRONEPHROSIS PERFORATION CAUSING PERITONITIS,PERICO LIC ABSCESS,FAECAL FISTULA ADHERENCE TO PSOAS MUSCLE POSTERIORLY INVADE UTERUS,OVARY ABSCESS IN LATERAL ABDOMINAL WALL
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- 11. LIVER METASTASIS • COMMONESTSITE-SPREADS VIA PORTAL VEINS • ENLARGED LIVER WITH HARD UMBILICATED NODULES • JAUNDICE • DARK COLOURED URINE • LOSS OF APETITE,WEIGHTLOSS • NAUSEA VOMITTING • CONFUSION • ASCITES
- 12. LUNG METASTASIS • COUGHWITH OR WITHOUT BLOOD • RECURRENT RESPIRATORY INFECTIONS • HOARSENESS • WHEEZING • SHORTNESS OF BREATH
- 13. BONE METASTASIS • BONEPAIN • MUSCLE WEAKNESS AND NUMBNESS • WEAK BONES WITH INCREASED SUSCEPTIBILITY TO FRACTURE • INCREASED SERUM CALCIUM LEVEL • BONE MARROW SUPPRESSION
- 14. MODIFIED DUKE’S CLASSIFICATION A: GROWTH LIMITED TO BOWEL WALL B : INVADES INTO EXTRABOWEL TISSUES BUT NO LYMPH NODES ARE INVOLVED B1 : INVADING MUSCULARIS PROPRIA B2 : INVADING INTO OR THROUGH SEROSA C : LYMPH NODE SECONDARIES D : DISTANT SPREAD