Abarca AF, Abarca RF, Andrade ZT, Kury GM

Language: Spanish
References: 9
Page: 129-133
PDF size: 174.36 Kb.

ABSTRACT

Patient of 69 years-old male, married, farmer, who went to our private office with colonoscopy diagnosed of tumor of the right colon and has to be treated for surgical resolution. According to his medical history his symptoms began approximately a month and half ago with dyspeptic syndrome specially irregularity in the habit intestinal with frequently diarrheas, asthenia, paleness of teguments and frequently abdominal pain. The physical exam showed patient in stable condition, the tumor can be felt in the abdominal area abdominal established in flank and left ileal fosse, with a hard consistency, unmovable, and painless. Rectal tact seemed normal, there was no edema in the lower extremities, the rest of patient exploration was normal and no one node was found. Diagnose and results: Clinical analysis, the Ht 24.4%, Fe in blood 12.1 (N:60-120), CEA 6 ng/L (N: 5-10), colonoscopy result includes a large tumor in the “right” colon, biopsies were taken and showed no maligned cells. Abdominal TC scan showed that the patient has a total “situs inversus” and a big mass that occupies the whole of left lower abdomen. Due to the results showed by colonoscopy and TC san the patient had been scheduled for elective surgery, before the preparation of the colon with oral phosphate. Findings and treatment: A laparotomy exploration being making a medial abdominal incision confirming the results showed by laboratory test that the patient has a total situs inversus and a tumor mass that occupies half of the right colon and about 6 cm of distal ileum close to cecum, we preceded to perform a radical right hemicolectomy with manual anastomosis. Postsurgical evolution: Excellent, the patient is released from hospital after five days. Final diagnose: Pathological report Lymphoma MALT of a lower grade of compromise in the intestinal wall and 9/36 lymph nodes had metastasis. We have performed the system of Ann Arbor modified by Musshoff in the grade II 1E.

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