2019 Volume 27 Issue 1 Pages 15-18
Background: The aim of the present study was to determine the optimal treatment strategy for patients with acute obturative intestinal obstruction due to colonic cancer.
Patients and Methods: We analyzed the results of examinations and treatments of 46 patients with tumors of the colon complicated by Colonic obstruction (CO) in the Department of Surgery, Tashkent Medical Academy from 2013 to 2018.
Results: Thirty-nine patients (84.7%) at the histological examination had adenocarcinoma of the colon. In 5 (10.9%) cases, the tumor were diagnosed as cricoid cell carcinoma, whereas in 2 (4.4%) patients, the diagnosis was undifferentiated carcinoma. A significantly high proportion of patients (62.9%) at the time of admission to the clinic had a severe stage of CO. All of them underwent X-ray of the abdominal cavity, ultrasound, multi-slice computed tomography; (MSCT) and colonoscopy, and had their laboratory data analyzed. Only 3 (6.6%) cases were diagnosed as CO due to colonic tumor in prehospital stage. The remaining cases were diagnosed as acute colonic obstruction (ACO) which is only acute intestinal obstruction. In the preoperative period, ultrasound examination revealed intestinal impassability without specifying the localization of obstruction in 92% of the cases. The presence of collapsed loops of the small intestine was one sign of colonic obstruction which may progress as “closed intestinal loop”.
Conclusion: X-ray and ultrasound examinations of the abdominal cavity revealed the presence of intestinal obstruction without specifying the localization of obstruction. The extent of surgical intervention should be determined differentially depending on the severity of the intestinal obstruction, peritonitis, the degree of tumor progression, the condition of the patient and accompanying pathology.
