Too young for colorectal cancer?
Talking about young patients with colon cancer, here’s another young man with rectal cancer about a month ago… He is 33 years old.
A hard area on the inside lining of the rectum
He had passage of blood mixed in the motion for a few months. It was fortunate that he was seen early by a gastroenterologist who found a hard area in the rectum on finger examination and proceeded to colonoscopy. He was surprised to find that the pathology report was positive for cancer, but a repeat biopsy also yielded the same result. There were no polyps in the colon and rectum.
A low “anterior resection” (i.e. resection of the rectum but preserving the anus) was performed. Fortunately, this cancer was in an early stage, and he required no further therapy.
It is uncommon for the under 50 population to suffer from colorectal cancer, except in specific high-risk circumstances such as familial adenomatous polyposis (multiple polyps in the colon and rectum), hereditary non-polyposis colorectal cancer (very strong family history of colorectal cancer) and prolonged history of ulcerative colitis (a form of inflammatory bowel disease).
However, any patient who presents with rectal bleeding needs to be examined. Do not refuse a physical examination, at least a finger rectal examination : it helped save this young man.
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.
Totally N.O.T.E.S.
N.O.T.E.S. = Natural Orifice Transluminal Endoscopic Surgery
Right after the publication of a report of transvaginal cholecystectomy by a team of New York doctors, an independant team of surgeons in France published videos of Operation Anubis.
An illustration of the procedure.
The NOTES multidisciplinary team led by Professor Jacques Marescaux.
On April 2nd 2007, at the University Hospital of Strasbourg, Professor Jacques Marescaux and his team, B. Dallemagne, MD, S. Perretta, MD, D. Mutter, MD, PhD, FACS, A. Wattiez, MD, D. Coumaros, MD, successfully performed the first no scar surgery. This first human incisionless operation was carried out using a flexible endoscope for transvaginal cholecystectomy in a 30-year-old woman with symptomatic gallstones.
The New York operation was carried out with laparoscopic ports in place in order to assist in case of problems with the NOTES. However, the French team performed the procedure completely scarless.
You can view the video of the procedure if you register in Websurg.
Another “kembang” moment!!!!!
The HOT MAMA Eastcoastlife appeared in an interview by Martin Lidsey on MartyBLOGs today.
And *drumroll* she names MOI as one of her frequent reads.. woohooo! I’m in cloud nine times nine liao 
