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Abstract: A 42-year-old male patient reported that he did not have symptoms such as abdominal pain, nausea, vomiting, urgency, mucus and blood in stool, and feeling of anal swelling, etc. He came to our hospital 1 day ago for further examination after a routine physical examination revealed an occupying transverse colon. After systematic examination, the patient was diagnosed with colon cancer and was operated and given oral medication, and his condition was controlled.
Basic information】Male, 42 years old
Type of disease】Colon cancer
Hospital】The First Affiliated Hospital of Xi’an Jiaotong University
Date of consultation】March 2022
Treatment plan】Surgical treatment (laparoscopic right hemicolectomy) + oral medication (roxithromycin capsules, azithromycin tablets) + intravenous injection (fluorouracil injection)
Treatment period】In-hospital treatment for 15 days, regular outpatient review
Treatment effect】Stable condition, no uncomfortable symptoms
I. Initial consultation
The first time we saw the patient, the patient reported that he had discovered the presence of transverse colon occupancy during the physical examination one day ago, and the symptoms were not accompanied by abdominal pain, nausea, vomiting, shortness of breath, mucus and blood in the stool, and anal swelling. After detailed questioning, we learned that the patient had a history of hypertension and usually took medication regularly. During physical examination, we found that the patient’s abdomen was soft, no mass was found, and there was no rebound pain with slight pressure in the upper abdomen.
Treatment process
After informing the patient of the presence of colon cancer, and after fully communicating with the patient and obtaining his approval, laparoscopic right hemicolectomy was determined to be performed as soon as possible. After general anesthesia, abdominal puncture was performed, and the hepatic flexure of the colon and the right hemicolectomy were separated from the middle part of the transverse colon, and the end of the ileum and the right side of the transverse colon were resected, and finally the left side of the transverse colon and the end of the ileum were anastomosed. After the patient was awake, he was safely returned to the ward. After the operation, the patient was given roxithromycin capsules and azithromycin tablets for anti-infection treatment and fluorouracil injection for chemotherapy to prevent the spread of cancer cells.
III. Treatment effect
On the first postoperative day, the patient’s vital signs were stable and his mental status was acceptable, indicating that the operation went well. Fifteen days after surgery, the patient reported no obvious symptoms after taking anti-infective drugs and chemotherapy, and the surgical incision recovered well.
IV. Precautions
As the patient’s condition was gradually controlled and he could be discharged home, I felt very relieved. At the time of discharge, I advised the patient to eat more celery, lettuce, bananas, cucumbers and other foods with high crude fiber content, and drink more warm water to help prevent constipation and avoid prolonged sitting and standing. Keep a calm mind, get enough sleep, keep warm, and do not do heavy physical work or exercise for a short period of time. In addition, you should go to the clinic for review on time, adhere to chemotherapy, and I will also reasonably adjust the treatment medication with the patient’s condition.
V. Personal insight
Clinically, some patients may not have obvious discomfort after the disease, like the 42-year-old male patient in this case, who usually did not have any adverse symptoms, but after physical examination, the presence of transverse colon occupancy was shown and further examination confirmed the diagnosis of colon cancer, but the patient need not worry too much. From this case, we can learn the benefits of regular medical checkups.