Particularities of Diagnosis and Treatment in a Case of Synchronous Colorectal Cancer

Abstract

In literature, synchronous colorectal cancer refers to the simultaneous presence of two or moremalignant lesions located along different segments of the large intestine or separated by at least 4cm, detected either pre-, intraoperatively or after maximum 6 months since a surgery addressed to acolon tumor. The incidence of synchronous tumors is approximately 3,5% of all cases of colorectalcarcinoma, while in others it reaches up to 8,4%. It is believed that this difference is mainly due tofalse negative results. The present paper presents the case of a 75-year-old patient, with a history ofessential hypertension and type 2 insulin-requiring diabetes who came to the emergency roomaccusing diffuse abdominal pain and bloating accompanied by the absence of intestinal transit forfecal matter over the past 6 days and an episode of vomiting. The results of the investigationscorrelated with the patient’s symptomatology indicate the diagnosis of bowel obstruction. Theexploratory laparotomy reveals an ulcero- vegetative, partially stenotic mass lesion in the sigmoidcolon with a diameter of about 5/6 cm. A second ulcero-vegetative, stenotic mass was identified atthe hepatic flexure of the colon with a diameter of approximately 8/7 cm. No metastatic lesions onthe liver or in the abdominal cavity were noted. Right hemicolectomy with end-to-endileotransverse-anastomosis and end-to-end colorectal anastomosis were performed. The presentpaper aims to expose the particular aspects of the diagnosis and treatment of bowel obstruction bysynchronous tumors on a patient with abdominal symptomatology attenuated on the background ofneurological complications of diabetes.