Emergency total proctocolectomy in an uninsured patient with Familial Adenomatous Polyposis Syndrome and acute lower gastrointestinal hemorrhage in a community hospital: A case report

Oviedo, Rodolfo J.; Dixon, Bruce M.; Sofiak, Chase W.

doi:10.1016/j.ijscr.2016.07.052

Cited by 3 publications

(3 citation statements)

References 14 publications

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“…Elective colectomy is generally done in late teens or early twenties if there is less number (< 10) of adenoma or small-sized (< 5 mm) adenomas. Early colectomy should be done if the patient is symptomatic with gastrointestinal bleeding, there are many 6 to 10 mm polyps which cannot be cleared by endoscopic polypectomy or there is marked increase in number of colon polyps in consecutive colonoscopies [36,37]. Urgent colectomy should be considered if there is adenoma with high-grade dysplasia, or suspected or documented CRC.…”

Section: Penetrability Of Colonoscopy In General Populationmentioning

confidence: 99%

Colon Cancer: A Clinician’s Perspective in 2019

2020

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Colon cancer is a common preventable cancer. With the adoption of widespread colon cancer screening in the developed countries, the incidence and mortality of colon cancer have decreased in the targeted population. But unfortunately, the incidence and mortality of colorectal cancer (CRC) have been increasing over the last 25 years in the young adults below the age of 50. There is disparity in benefit, i.e. reduction in risk of death between right-sided and left-sided colon cancer by screening colonoscopy. The reason could be multifactorial and various measures have been taken to decrease this disparity. Although most of the screened populations are average risk individuals, a minority of the population have various risk factors for developing colon cancer and need to follow specific colon cancer screening guidelines. Gene mutations (adenomatous polyposis coli (APC), deleted in colon cancer (DCC), K-ras, p53, B-Raf proto-oncogene serine/threonine kinase (BRAF), mismatch repair genes) and microsatellite instability lead to the development of colon cancer. Although various non-invasive methods of colon cancer screening are now available, colonoscopy remains the gold standard of colon cancer screening and adenoma detection rate is now being used as the quality metrics in screening colonoscopy. Although Multi-Society Task Force (MSTF) and American College of Physicians (ACP) recommend initiating screening colonoscopy at age 50 years in all individuals except African Americans who should begin screening colonoscopy at age 45 years, the American Cancer Society (ACS) recommends initiating screening colonoscopy at age 45 years in all individuals irrespective of race and ethnicity. Low-volume split-dose prep has been found to be as effective as high-volume split-dose prep and more tolerable to patients with increased compliance. Boston bowel preparation scale is recommended to measure the quality of colon cleansing. CRC is curative if it is diagnosed at an early stage but various palliative treatment options (endoscopic, oncologic and surgical) are available in advanced stages of this cancer. Adequate number of lymph node assessment during surgery is essential in accurate staging of CRC. Checkpoint inhibitors have been found to have dramatic response and durable clinical benefit in dMMR/MSI-H metastatic CRC. Different genetic and immune-oncologic research trials are ongoing for early detection and better management of CRC.

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Section: Penetrability Of Colonoscopy In General Populationmentioning

confidence: 99%

Colon Cancer: A Clinician’s Perspective in 2019

2020

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“…Massive lower GI bleeding with attendant class four shock from FAP is a rare occurrence as well as requiring urgent surgical intervention after investigation with Oviedo et al . reporting of such a case in an African American male [ 6 ]. Four cases have been previously reported in a Nigerian population [ 7 ], but this is the first of its kind in a Ghanaian population to the best of our knowledge.…”

Section: Discussionmentioning

confidence: 99%

Familial adenomatous polyposis: a case study

Yorke

Yamoah

Awoonor‐Williams

et al. 2020

Journal of Surgical Case Reports

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Familial adenomatous polyposis (FAP) is an inherited syndrome characterized by several adenomatous polyps of the gastrointestinal (GI) mucosa. If treatment is not provided, an average individual with classic FAP will develop colorectal carcinoma around the age of 40 years. The incidence rate of FAP in developing countries like Ghana is unknown compared to advanced countries. We present the first FAP case of a 22-year-old Ghanaian female who presented with massive lower GI bleeding and underwent surgical management after a thorough investigation. The initial assumption that colonic polyps are scarce in native Africans may be more than what is perceived. This highlights the need for the availability of endoscopic services in Ghana.

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“…The second case was most likely a case of attenuated FAPS because the number of polyps viewed at colonoscopy was less than 100. The two patients presented with rectal bleeding which is the most common presentation in FAPS [ 9 , 10 ]. First-degree relatives need rigorous screening and will need to have colonoscopy once every year.…”

Section: Discussionmentioning

confidence: 99%

Familial adenomatous polyposis syndrome with colorectal cancer in two Nigerians: a report of two cases and review of literature

Bojuwoye¹,

Olokoba²,

Ogunlaja³

et al. 2018

Pan Afr Med J

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Familial adenomatous polyposis syndrome is a rare condition characterized by the presence of numerous adenomatous polyps in the gastrointestinal tract and associated with risk for colorectal cancer. The disease is scarcely reported in Nigeria and this is the index report in Ilorin. Two cases were clinically diagnosed in our facility. They both presented with gastrointestinal bleeding and numerous rectal and colonic polyps were identified at colonoscopy. Histological examination of the polyps in both cases revealed features in keeping with adenomatous polyps. This report highlights the occurrence of this precancerous condition.

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Emergency total proctocolectomy in an uninsured patient with Familial Adenomatous Polyposis Syndrome and acute lower gastrointestinal hemorrhage in a community hospital: A case report

Cited by 3 publications

References 14 publications

Colon Cancer: A Clinician’s Perspective in 2019

Colon Cancer: A Clinician’s Perspective in 2019

Familial adenomatous polyposis: a case study

Familial adenomatous polyposis syndrome with colorectal cancer in two Nigerians: a report of two cases and review of literature

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