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Query: UMLS:C0009402 (colorectal cancer)
 53,228 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

This article describes two patients with hepatic metastases from colorectal cancer in whom a reversible enteropathy developed during the administration of hepatic artery infusion chemotherapy with 5-fluoro-2-deoxyuridine (5-FUdR) via an Infusaid Series 400 pump (Infusaid Corp., Sharon, MA). Both patients had severe diarrhea and signs that suggested small bowel obstruction. Barium studies revealed a distinctive radiologic appearance of severe narrowing of the ileum associated with complete loss of normal mucosal patterns. Results of an extensive evaluation for an infectious or toxin-related enterocolitis were negative. Perfusion studies confirmed the appropriate position of the catheters and revealed no extrahepatic perfusion. Systemic shunting of the 5-FUdR through the liver or tumor bed is postulated as the primary event, with the small bowel manifesting the major toxicity.
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PMID:A reversible enteropathy complicating continuous hepatic artery infusion chemotherapy with 5-fluoro-2-deoxyuridine. 293 Nov 70

About one third of the patients with colorectal cancer presents with large bowel obstruction, perforation or life threatening bleeding. In large bowel obstruction there is a trend towards primary resection and immediate anastomosis, also in cancer of the left colon. Among the techniques used are orthograde irrigation and primary resection with colo-colonic anastomosis, and in selected cases subtotal colectomy with ileosigmoid or ileorectal anastomosis. For sigmoid neoplasms causing obstruction immediate resection and end colostomy is recommended. In perforation at the tumour site, primary resection and immediate anastomosis may be justifiable if the peritonitis is localized. If diffuse peritonitis is present, primary resection with end colostomy seems to be the best choice. Although primary resection with or without immediate anastomosis has its merits, staged resection still remains a good and safe alternative in many cases.
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PMID:Surgical procedures in colorectal cancer emergencies. 320 Nov 49

From 1982 to 1986, after radical surgery (S) for carcinoma of the rectum and rectosigmoid colon, 25 consecutive patients were entered into a Phase I/II study exploring adjuvant radiation (RT). The latter was given with a single fraction of whole abdomen (mid-body) irradiation (MBI), followed by conventional whole pelvis irradiation (WPI). The minimum follow-up time was 12 months, and the maximum was 44 months. There was escalation of the single MBI dose: 5 Gy in 11 patients, 6 Gy in two patients, and 8 Gy in 10 patients. The 2-year survival rate has been 100 and 45% for Stages B2 and C patients. Only 1/7 Astler-Coller Stage B2 patients failed; this failure was in the lungs. Seven of 15 patients with Stage C failed: one locally, three in the liver, and three in the lungs. Single MBI doses greater than 5 Gy have yielded a high incidence of intestinal obstruction when combined with routine WPI. Consequently, this combination requires both some modification and careful attention if used in future trials exploring new treatment approaches for colorectal cancer.
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PMID:A phase I/II trial of whole-abdominal plus pelvic irradiation for Astler-Coller stage beta 2, C colorectal cancer. 327 76

Two cirrhotic patients with a LeVeen shunt presented with a large bowel cancer. In one patient, the shunt was removed and the venous catheter was ligated prior to the performance of a colon resection. The postoperative course was uneventful. A new valve was inserted and connected to the venous catheter two months later. The second patient had a carcinoma of the rectum. In order to prevent ascites and to ease the colorectal resection he had preliminary construction of a portacaval shunt. Six weeks later, he underwent an anterior resection of the rectum. The postoperative course was uneventful except for a self limiting episode of febrile subacute intestinal obstruction. These two cases demonstrate that it is possible to resect colorectal cancer in patients with cirrhosis, ascites and a peritoneovenous shunt provided measures are taken to avoid specific complications due to the presence of the shunt, ascites or portal hypertension.
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PMID:Management of colorectal cancer in patients with cirrhosis and a LeVeen shunt. 361 May 39

Small bowel obstructions, which account for two-thirds of all intestinal obstruction, are caused by adhesions, hernias and cancer. Large bowel obstructions are usually the result of a malignancy, but may also be caused by diverticulitis or volvulus. Previously treated individuals with a known diagnosis of advanced cancer originating in the pelvis are at highest risk for developing intestinal bowel obstruction. Since 30 percent of Americans will develop cancer in their lifetimes, and colorectal cancer is the most common type, this represents a significant population at risk to be followed by nurse practitioners. The pathophysiology, assessment and management of an individual with a bowel obstruction is reviewed. Morbidity and mortality in this population is high. Wound healing problems, including infection, dehiscence, evisceration and fistula formation, contribute significantly to the morbidity and can cause long-term problems. In today's health care system, it's likely that patients will be discharged from the hospital earlier after bowel surgeries. Therefore, nursing care focusing on wound management is outlined.
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PMID:Diagnosis and management of intestinal obstruction in individuals with cancer. 394 19

A retrospective review of 30 patients under 40 years of age with colorectal cancer is described. Sex ratio was almost equal. The presenting symptoms depended on the localisation of the tumor, and the length of the clinical history averaged 18 weeks. No correlation was found between duration of symptoms and prognosis. 26 patients were operated on electively. In 3 patients the tumor was found by chance and one case presented with intestinal obstruction. Left-sided tumor location was found in 73%. Patients with right-sided tumors had a slightly better prognosis (p = NS). Radical surgery was performed in 20 patients (67%). The operative mortality was 0%. Localized cancer was found in 12 patients, and 18 patients had lymph nodes or distant metastasis. 11 patients (37%) have survived 5 years or more. It is concluded that colorectal cancer in patients under 40 differs in no respect from the disease in older patients.
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PMID:[Colorectal carcinoma in persons under 40 years of age]. 408

The present study examines the prognostic significance of tumor location and bowel obstruction in Dukes B and C colorectal cancer. Data were obtained from 1021 patients entered into two randomized prospective clinical trials of the NSABP. Tumor location proved to be a strong prognostic discriminant. Lesions located in the left colon demonstrated the most favorable prognosis. Tumors of the rectosigmoid and rectum had the worst prognosis with the relative risk of treatment failure for the latter being over three fold that of the left colon. When the relative risks associated with tumor location were adjusted for nodal imbalances, the left colon continued to demonstrate the most favorable prognosis. The presence of bowel obstruction also strongly influenced the prognostic outcome. Examination of the data without considering tumor location disclosed that patients with bowel obstruction were at greater risk for treatment failure than those without obstruction. The effect of bowel obstruction was influenced by the location of the tumor. The occurrence of bowel obstruction in the right colon was associated with a significantly diminished disease-free survival, whereas obstruction in the left colon demonstrated no such effect. This phenomenon was independent of nodal status and tumor encirclement, the latter two factors proving to be of prognostic significance independent of tumor obstruction. A multivariate analysis in which the covariate effects of sex, age, nodal status, tumor obstruction, encirclement, and tumor location were adjusted underscored the role of tumor location and obstruction as prognostic discriminants. The results indicate that the definition of prognostic factors can identify patient subsets with unique characteristics.
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PMID:The prognostic significance of tumor location and bowel obstruction in Dukes B and C colorectal cancer. Findings from the NSABP clinical trials. 635 18

Three cases of metachronous adenocarcinoma of the large and small bowel are reported. The small-bowel lesions were not even suspected preoperatively and were diagnosed after extensive pathologic study. Though rare, metachronous primary carcinoma of the small bowels must be considered in a patient with intestinal obstruction or hemorrhage following colorectal cancer surgery. Pre-operative diagnosis, which demands a high index of suspicion and careful technical evaluation, is crucial in determining the overall surgical management of the patient.
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PMID:Metachronous primary carcinoma of small bowel following resected colorectal carcinoma: a report of three cases. 696 34

A decade ago intestinal obstruction was the commonest cause of general surgical abdominal emergency admissions in many tropical African countries. Recently there has been a change in this pattern and acute appendicitis has become the major cause of emergency admissions. Most cases of intestinal obstruction are due to obstructed (strangulated or incarcerated) groin hernia. Intestinal ascariasis is a declining cause of intestinal obstruction while colorectal cancer is now an important differential diagnosis. Trauma due to road traffic accidents is increasing in frequency. Gallbladder disease is not a major problem; symptoms suggestive of acute gallbladder disease are more likely to be due to an amoebic abscess in the West African environment.
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PMID:Abdominal emergencies in a tropical African population. 722 63

The records of 66 consecutive patients who developed intestinal obstructions after treatment for cancer were reviewed. Approximately one third of the patients were found to have a benign cause of obstruction. The chances that an obstruction was due to cancer were increased if the patient had known metastatic cancer, previous colorectal cancer, if the primary was an advanced stage, and if the interval since treatment of the primary was short. Incomplete obstructions were treated with nasogastric suction. Although resolution of the obstruction on nasogastric suction without operation occurred in 24% of the admissions, 41% of those patients had to be readmitted for surgical relief of recurrent intestinal obstruction. Resolution of an obstruction on nasogastric suction occurred early, and there was little point in continuing a trial of suction for longer than 3 days.
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PMID:Malignant intestinal obstruction. 737 72


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