Constricting type of colonic carcinoma is seen in
Correct Answer: Left colon
Description: Ans. a (Left colon). (Ref. Bailey and Love, 25,h/pg. 1179)Carcinoma ColonSiteClinical presentationCarcinoma of the left side of the colon- Most tumours occur in this location. They are usually of the stenosing variety. Left-sided tumours: rectal bleeding, alteration in bowel habit, tenesmus, obstruction.- The main symptoms are those of increasing intestinal obstruction.- Alteration of bowel habit. An adult previously having a predictably regula bowel habit suddenly develops irregularity.- The episodes of constipation may be followed by attacks of diarrhoea.- Distension. Lower abdominal distension is not uncommon and, as with the pain, is relieved by passing flatus.Carcinoma of the sigmoid- This follows the general pattern of the above, with these differences:- Pain is usually colicky from the outset.- Tenesmus. Low tumours may give rise to a feeling of the need for evacuation, which may result in tenesmus accompanied by the passage of mucus and blood, especially in the early morning.- Bladder symptoms are not unusual and in some instances may herald a colovesical fistula.Right-sided tumours- iron deficiency anaemia, abdominal mass are presenting features.Carcinoma of the transverse colon- This may be mistaken for a carcinoma of the stomach because of the position of the tumour together with anaemia and lassitude.Carcinoma of the caecum and ascending colon* Anaemia, severe and unyielding to treatment; there may be a palpable tumour present.* The presence of a mass in the right iliac fossa. Colonoscopy may be needed to confirm the diagnosis.* Caecal carcinoma is sometimes discovered unexpectedly at operation for acute appendicitis or for an appendix abscess failing to resolve. On rare occasions the appendix is inflamed, or even gangrenous, from the obstruction to its lumen by the tumour.* A carcinoma of the caecum can be the apex of an intussusception presenting with the symptoms of intermittent obstruction.
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