Synchronous Bilateral Flexure Tumor Causing Ileus and Requiring Surgical Treatment

Abstract

This case report presented a simultaneous right colon tumor detected perioperatively in a patient who developed ileus due to a metastatic left colon tumor in the preoperative period. A seventy-six-year-old man was admitted with epigastric pain, nausea, and vomiting. There was tenderness and defense on deep palpation on the epigastrium. On computed tomography, there were multiple hypodense lesions on the liver, a mass at the level of the splenic flexure that obliterates the lumen. In addition, there were numerous air-fluid levels due to tumoral mass on splenic flexure. Emergency surgery was performed, and during surgery, there were tumoral masses at the hepatic flexure and splenic flexure. Palliative total abdominal colectomy with end ileostomy was performed due to megacolon. The patient died due to sudden cardiac arrest on the 1st postoperative day.

Keywords

• Colorectal cancer
• intestinal obstruction
• synchronous neoplasms

İleusa Neden Olan ve Cerrahi Tedavi Gerektiren Senkron Bilateral Köşe Tümörü

Abstract

Bu olgu sunumunda, preoperatif dönemde metastatik sol kolon tümörü nedeniyle ileus gelişen bir hastada perioperatif dönemde saptanan eş zamanlı sağ kolon tümörü sunulmaktadır. Yetmiş altı yaşında erkek hasta epigastrik ağrı, bulantı ve kusma şikayetleriyle başvurdu. Derin palpasyonda epigastriumda hassasiyet ve defans mevcuttu. Bilgisayarlı tomografide karaciğerde çoklu hipodens lezyonlar, splenik fleksura seviyesinde lümeni oblitere eden bir kitle vardı. Ayrıca splenik fleksuradaki tümöral kitleye bağlı olarak çok sayıda hava-sıvı seviyesi mevcuttu. Acil cerrahi uygulandı ve ameliyat sırasında hepatik fleksura ve splenik fleksurada tümöral kitleler görüldü. Megakolon nedeniyle palyatif total abdominal kolektomi ile uç ileostomi yapıldı. Hasta ameliyat sonrası 1. günde ani kalp durması nedeniyle kaybedildi.

Keywords

• Kolorektal kanser
• bağırsak tıkanıklığı
• senkron neoplazmlar

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