Intestinal obstruction is intestinal obstruction
The cardinal signs of intestinal obstruction are abdominal pain and bloating, vomiting and inability to pass motion or flatus. When a patient comes with these symptoms, it is usually a surgical emergency. The main causes to consider would be either a physical block in the intestine, or a loss of peristaltic movement of the intestine.
This 25-year-old man came from a hospital in the neighbouring state with intestinal obstruction. They had already performed a colonosopic examination and an obstruction was found in the colon. For some reason, an operation was not performed.
He came to my hospital and I decided that an urgent laparotomy was needed. The abdomen was extremely bloated already. This was what was found:
A tumour in the colon. It was resected.
Slicing it open lengthwise, the tumour could be seen.
Whatever the age of the patient, obstruction is obstruction. The point is, obstruction due to a mechanical cause needs a laparotomy to relieve it. No matter what the age of the patient.
I’ll pass on those pictures, if you don’t mind!
OMG, 25y.o with tumor in colon?? *faster go eat colon detox products*
Ah, Bernard is back! This poor man. So, what is going to happen now. Will he have a normal life?
By the way, I just had two huge serves of dinner and looking at this, I don’t feel sick anymore. Getting used to your pictures.
DOC!
I’m not trained to detect tumours with my eyes, could you please circle the portion I should be looking at, heh
Captain, click on the “back” button!
Soo, what kind of “detox”??
Judy, it’s unfortunate that it happened to such a young man. The age sometimes throws us off the right track.
The intestines were emptied of 2 weeks worth of faeces and the ends joined together (primary anastomosis). The bowel started functioning after 4 days and he went home on normal diet after 6 days. He is expected to have a normal functioning intestinal system.
However, there were tumour seedings elsewhere in the abdomen (i.e. the tumour had spread). So, he would require chemotherapy after wound healing.
Pelf, sure… marked in red.
Only 25 years old!! I am shocked at the mess/mass in the intestine. At this stage, would chemo completely halt and destroy the tumour development?
First time in my life looking at intestine. *shock*
I wish mine was not as serious as his case…*pray hard and pass motion hard*…
Hi Dr. Bernard ,
I too wasn’t too sure about the CA part . Are there any macroscopical signs that let us determine it’s a tumour ??
Oh my, really shocking. This cut out portion to be thrown away right?
I have never imagined a tumour to look that inconspicuous, to a layperson’s eyes anyway.
And when I saw the first half of your first picture (as I was scrolling down), I though it was a picture of corals in the sea. :/
Haha.
OK.. Thanks for the illustrations, but the circled areas don’t look any different that other portions..
OK, that’s why I’m NOT a doctor, LOL.
aiyer…the pic so wat tat lah….
Liling, there’s a chance it might. The survival after stage IV colorectal cancer is 10% in five years. So there’s still a chance.
Adino, welcome!
Chelsea, always get examined. Not always need a colonoscopy. But always need to examine.
SV, u mean clinical symptoms?
* rectal bleeding or passage of mucus
* recent change in bowel habit
* obstruction
* anaemia
or macroscopic pathological features?
* ulcerating
* fungating / exophytic
* annular / surrounding the lumen
Hoiling, yes.. that’s the resected segment.
Anastasia, well.. once you’ve seen it, you’ll remember.
Pelf, ya well.. i’ll see whether I can find better pictures.
Bibik, oops.. sorry.
how did he know from the first place…normal stomach ache?
He had intestinal obstruction already when he came to hospital.
He was unable to pass motion and wind, the abdomen was bloated, he was vomiting all that he was eating.
He might have had some earlier symptoms but he didn’t come earlier.
yup.. i meant the latter.
Thanks for the explaination. 
Hey Bern, Good to see your updates and pics. Did you get a chance to check if the remaining part of the colon was healthy?