Perforated colon cancer overview, 1. Etiology:
May be due to carcinoma invasion through the intestinal wall, or may cause obstruction of the tumor, which leads to proximal intestinal perforation. Side of the colon perforation in type more common version of swelling, acute perforation of the left colon perforation Zeyi common.
2. Clinical manifestations:
(1) acute perforation peritonitis model: most of the tumor before perforation obstruction symptoms, perforation into the abdominal cavity because of intestinal content logistics, resulting in diffuse peritonitis. Before perforation in patients with different degrees often accompanied by abdominal pain, bloating and other symptoms of low intestinal obstruction, perforation may occur after the peritoneal irritation sign, x-ray shows free air under the brain and expansion of the bowel and so on.
(2) subacute perforation Edition swollen type: this type of perforation of small intestine proximal to the tumor without obstruction, the pressure of small intestine, colon contents into the abdominal cavity with low logistics perforation local tumor infiltration, inflammation and the formation of adhesions to the surrounding tissue encapsulated swelling or inflammatory mass service. No clinical patients with multiple clinical manifestations of acute abdomen, until the formation of abdominal swelling local version, the patient may present limitations of abdominal pain, persistent high fever, elevated blood, abdominal tenderness touched obvious mass. Such as occurred in the right lower abdomen, often misdiagnosed as appendicitis swelling around the edition.
(3) chronic perforation of the thin type: invasive growth of colon cancer to surrounding tissue and adjacent organ involvement, and their adhesion, when the primary foci central necrosis and perforation, can penetrate the adjacent organ involvement and the formation of various types of the thin, thin common are colon ileum, jejunum, colon thin, thin, and end the stomach and duodenum colon thin, individual cases of bladder colon may appear thin, skinny vagina, uterus desolate and thin skin, the colon through the skin.
Colon perforation overview 3. Diagnosis:
Perforation of the colon secondary to many causes, all colonic lesions can lead to colonic perforation, therefore, preoperative diagnosis of colon perforation is not easy. Should be carefully asked about the history and detailed physical examination, combined with the necessary auxiliary examination, preoperative diagnosis of some help, check commonly used in X-ray, colonoscopy, B ultrasound or CT examination, etc., should be selected according to the specific circumstances of the patient application.
(1) the treatment of acute perforated peritonitis: In addition to colon perforation caused by acute diffuse peritonitis, the cancer may spread in the abdominal cavity, planting, it should strive to do the surgery in a short time before the necessary preparations as soon as possible an operation. Choice of surgical methods available are: perforation is small, short, intra-abdominal contamination is not severe, for removal of cancer, a match. a resection of cancer, well, stump proximal colostomy, or stoma proximal to distal joints closed, the second match. suture of perforation, proximal colostomy, cancer surgery can do two, depending on the specific circumstances.
(2)-type colon cancer treatment of perforated version of swollen: swollen version of the formation of the cases there is progress, such as local inflammation, drainage should be removed again, the right colon and proximal transverse colon perforation caused by swelling of the line I of service tumor resection is feasible, the left colon, and distal transverse colon perforation caused by swelling of the service more staging surgery.
Colon perforation overview (3) treatment of colon cancer of the thin: this type of colon perforation often need intravenous nutrition to correct body position of the high to the surgery, I should generally be of radical resection and anastomosis for. Ruoyi the formation of the thin, indicating that the tumor is already advanced, there's a great possibility of tumor metastasis, five-year survival rate after radical operation were lower than non-thin.
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