Diagnosis of Cancer of the Left Colon, Complicated by Acute Intestinal Obstruction

Abstract

Between 2003 and 2012 in the Alexandrovskaya Hospital of St. Petersburg, Russia 2200 patients were hospitalized with cancer of the left colon complicated by acute intestinal obstruction, ageing from 26 to 91 years. 44.2% were men, 55.8% were women. The subjects of the study were 1019 patients in whom distant metastases had not been identifi ed. This study is an analysis of the role of physical, laboratory and instrumental methods of examining patients with acute intestinal obstruction due to cancer of left colon. Conclusions: 1. Up to 80% of patients were admitted to hospital aft er 48 hours from onset of the acute period of the disease, affecting the variability of clinical manifestations in acute intestinal obstruction due to cancer of left colon. 2. From instrumental methods, the most informative is X-ray examination. When ultrasound is characterized by a tensile intestinal loops. 3. Fibrocolonoscopy, with effectively implementation, allows for a 100% positive diagnosis, but only 13.7% of subjects go on to therapeutic manipulation. 4. Laparoscopy avoids a long-term observation of the passage of barium sulfate in patients with suspected acute intestinal obstruction and is the most effective way to determine the cause of intestinal obstruction in a complex of diagnostic measures. It is an effective diagnostic tool for fi rst-stage or final stage in the treatment of intestinal obstruction. 5. Computed tomography, having a sensitivity of 97.4% is the preferred method of detecting metastases to determine the source and extent of tumour growth which certainly can and should influence the decision as to adopt a surgical approach. Refs 10. Tables 9.