Right Colon Tumor Caused Lower Gastrointestinal Massive Bleeding

Öz

Colon cancer is a major health problem all over the world. Colon cancer can be diagnosed with an elective diagnosis as well as during emergencies such as perforation, obstruction or bleeding. Tumor-related bleeding is usually seen in right colon tumors, while left colon tumors usually present with obstructive symptoms. In this case report, it is aimed to present the diagnosis and treatment process of massive lower gastrointestinal bleeding caused by a giant right colon tumor. A 57-year-old male was admitted to general surgery clinic with lower gastrointestinal massive bleeding. He had hypotension, tachycardia and lower hemoglobin level (5.4 g/dL). He became hemodynamically stable after intravenous fluid replacement and blood product transfusion. After evaluation with colonoscopy and computed tomography, he had resectable giant right colon tumor. Emergency right hemicolectomy with anastomosis was performed. He was discharged on the 6th postoperative day. Pathology of the operation material was consistent with adenocarcinoma. The tumor dimensions were 120*80*25 mm. Surgical border was negative and there was a metastatic lymph node with 49 reactive lymph node.

Anahtar Kelimeler

• Colon tumor
• gastrointestinal bleeding
• hemodynamic shock.

Right Colon Tumor Caused Lower Gastrointestinal Massive Bleeding

Öz

Kolon kanseri tüm dünyada önemli bir sağlık sorunudur. Kolon kanseri, elektif bir tanı ile teşhis edilebileceği gibi, perforasyon, tıkanıklık veya kanama gibi acil durumlarda da konulabilir. Tümöre bağlı kanamalar genellikle sağ kolon tümörlerinde görülürken, sol kolon tümörleri genellikle obstrüktif semptomlarla karşımıza çıkar. Bu olgu sunumunda dev bir sağ kolon tümörünün neden olduğu masif alt gastrointestinal sistem kanamasının tanı ve tedavi sürecinin sunulması amaçlanmıştır. 57 yaşında erkek hasta alt gastrointestinal masif kanama ile genel cerrahi polikliniğine başvurdu. Hipotansiyon, taşikardi ve düşük hemoglobin (5,4 g/dL) vardı. Hasta intravenöz sıvı replasmanı ve kan ürünü transfüzyonundan sonra hemodinamik olarak stabil hale geldi. Kolonoskopi ve bilgisayarlı tomografi ile değerlendirildikten sonra hastada rezektabl dev sağ kolon tümörü mevcuttu. Anastomoz ile birlikte acil sağ hemikolektomi yapıldı. Postoperatif 6. günde hasta taburcu edildi. Ameliyat materyalinin patolojisi adenokarsinom ile uyumluydu. Tümör boyutları 120*80*25 mm idi. Cerrahi sınır negatif, 1 metastatik lenf nodu ve 49 reaktif lenf nodu mevcuttu.

Anahtar Kelimeler

• Kolon tümörü
• gastrointestinal kanama
• hemodinamik şok.

Kaynakça

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