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Abstract: The patient, grandmother Wang, was in good health without underlying diseases such as hypertension and diabetes mellitus. She was seen in our hospital for abdominal pain and diarrhea for 7 days, and the number of stools increased within 7 days and the nature of stools changed. The patient was discharged with no abdominal pain and diarrhea.
Basic information】Female, 69 years old
Disease Type】Malignant tumor of sigmoid colon
Hospital】The First Affiliated Hospital of Kunming Medical University
Date of Consultation】December 2021
Treatment plan】Surgical treatment (laparoscopic sigmoid colectomy)
Treatment Period】15 days in hospital
Results】Tumor was completely removed after surgery, no abdominal pain and diarrhea, and was discharged from the hospital.
I. Initial consultation
Grandma Wang is an old farmer, usually in good health, no hypertension, diabetes and other basic diseases, no familial genetic diseases, and she came to our hospital with abdominal pain and diarrhea for 7 days. She was briefly asked about her condition. There was no obvious cause for the pain in the middle abdomen, which was paroxysmal dull pain, relieved by defecation, no radiating pain, diarrhea 4 times/day, yellow thin stool, no blood stool, no dizziness, vomiting 3 times/day, small amount, vomit was stomach contents. External CT examination showed: segmental thickening of the proximal intestinal wall of the sigmoid colon and soft tissue mass in the lumen, gross plasma surface, malignant possible, please combine with microscopy. I told Grandma Wang that she needed to be hospitalized for further examination, and after discussion with Grandma Wang, admission was confirmed.
II. Treatment process
After admission, we completed the relevant preoperative ancillary tests for Grandma Wang, and the biochemistry, coagulation four, and infectious four were all normal, while the routine blood test revealed that hemoglobin: 100g/L, suggesting the presence of anemia; the stool occult blood test (+), indicating gastrointestinal bleeding; the enhanced CT of the abdominopelvic cavity showed a soft tissue mass on the mesenteric side of the upper sigmoid colon, with malignant possibility. The final diagnosis was malignant tumor of the sigmoid colon. After the diagnosis was clear, we communicated with Grandma Wang and her family that surgery was needed, and agreed to perform laparoscopic sigmoid colectomy in collaboration with the anesthesiology department, and waited for the return of pathological results, which showed: highly differentiated adenocarcinoma, invading the muscular layer, and no metastasis in lymph nodes.
III. Treatment effect
After routine postoperative treatment with water fasting, glucose rehydration, omeprazole acid suppression, and antibiotic anti-infection, Grandma Wang was advised to move on the floor on the 3rd postoperative day in order to reduce the risk of postoperative complications. After the surgical treatment, Granny Wang’s stool frequency decreased close to normal, blood in the stool disappeared, and abdominal pain improved significantly. 15 days after this hospitalization, the patient was successfully discharged. Grandma Wang said she will soon be able to work in the fields again and that a positive and optimistic attitude is helpful for the cure of the disease. Before discharge, Grandma Wang was advised to have regular post-operative follow-ups.
IV. Notes
We are very happy that Grandma Wang was successfully discharged from the hospital and returned to normal life. Although the surgery was successfully completed and she recovered well, patients should pay attention to the usual symptoms such as fever, redness and swelling of the surgical incision and pus flow after discharge, and if local or systemic abnormalities are found, it is recommended to follow up at the hospital in time. In addition, it is recommended to come to the hospital for regular rechecking of blood routine, carcinoembryonic antigen and colonoscopy to prevent tumor recurrence.
In terms of diet, it is recommended to eat less and more meals, more vegetables and fruits, and high protein diet. A good diet structure can keep the patient’s bowels open. Quit smoking and alcohol and maintain a positive and good attitude are also crucial to the recovery of the disease.
V. Personal insight
Sigmoid malignant tumor is a malignant tumor originating from the mucosal epithelial cells of sigmoid colon. The symptoms are relatively insidious in the early stage, and patients often have symptoms such as blood in stool, abdominal pain, abdominal distension, etc. They can also see an increase in the number of bowel movements and change in the nature of bowel movements. Among them, bloody stool is of great significance for the diagnosis of bowel cancer. If the above symptoms appear, seek medical consultation in time to avoid delaying the disease. Grandma Wang had a good prognosis because she was treated in time and cooperated with doctors with a positive and optimistic attitude. It is not uncommon that some patients do not pay attention to their health conditions and do not come to the clinic until they progress to advanced stage. We hope that patients and their family members can pay attention to the small symptom changes in daily life and seek medical consultation in time.