Presentation of Colorectal Carcinoma, A Local Experience

Abstract

Introduction: Colorectal carcinoma is the third commonest malignancy all over the world. In countries like Pakistan, mostly patients present first time in emergency department with fecal peritonitis or acute intestinal obstruction. These patients got worst prognosis and stormy post-operative time with high percentage of complications. Otherwise prognosis is excellent if diagnosed at stage I or II and treated properly. Objectives: To compare the common post-operative complications in large bowel malignancy in elective and emergency presentation. Material & Methods: It is a cross sectional retrospective study. Patients with histological proof of carcinoma were included in the study. Data over the period of two year was collected and analyzed. Results: This study included one hundred patients. Mean age was 49.56 years and 56 % of the patients were males. 40 % of the patients present between the ages of 40 to 60 yearsMean time of start of symptoms and the time of presentation in the hospital was 6.5 months ranges from 1 to 24 months. 76 %of the patients had history of altered bowel habits and 60% had anorexia and weight loss. 44 out 100 patients presented in the emergency. Rate of post-operative complications was much higher in those patients who admitted through emergency including leak from anastomotic site and wound dehiscence. Conclusions: All the patients of 50 years or more should be seen by surgeon for exclusion of large bowel carcinoma if they had symptoms of altered bowel habits associated with weight loss and anorexia. If the colonic carcinoma is diagnosed at an early stage, chances of life threatening post-operative complications are far less as compare to those who presented with advance stage.