The most commonest complication in patients with colorectal carcinoma is intestinal obstruction and the most commonest cause of large bowel obstruction in adult patients is colorectal carcinoma.
If intestinal obstruction is occurred secondary to colorectal carcinoma, it have poor prognosidue to low resectability because of very high rate of complication and advancement of cancer.
Generally, the principle was primary resection in right colon cancer and staged oepration after decompression or primary resection and proximal colostomy in left colon cancer. But nowdays primary resection in left colon cancer is common.
The study is clinical analysis and review of 43 cases of patients with acute colonic obstruction secondary to colorectal carcinoma among 327 cases of colorectal carcinoma treated surgically at the Pusan National Universty Hospital from January
1984
to
December 1993.
@ES The results obtained were summarized.
@EN 1) Of all 327 cases with colorectal carcinoma, the cases with acute colonic obstruction were developed in 43 cases. The ratio between male and female was 1.15:1 and peak age incidence was 6th decade.
2) The presenting symptoms and signs were abdominal pain (93.0%), abdominal distention (83.7%), constipation (76.7%), bloody or tarry stool (48.8%) weight loss (44.2%), poalpable abdominal mass (41.9%), vomiting (39.5%), anemia (23.3%) and bowel
perforation (4.7%).
3) The durations of obstructive symptoms were within 1 day in 4 cases (9.3%), within 1 week in 21 cases (48.8%), within 2 weeks in 15 cases (34.9%), over 2 weeks in 3 cases (7.0%), and the most prevalent interval between symptoms of colorectal
cancer
and obstructive symptoms on history taking was within 1 month, and average interval was 5 months.
4) According to locations of carcinoma, 21 cases (48.8%) occurred in left colon, 12 cases (27.9%) in right colon and 10 cases (23.3%) in rectum.
5) The operative procedures according to locations were as follows : in the right colon, primary resections were underwent in 11 cases (91.7%), decompression only in 1 case (8.3%), in the left colon, primary resections were underwent 11 cases
(52.4%),
staged operation 6 cases (28.6%), decompression only 4 cases (19.0%), and in the rectum, primary resection 7 cases (70.0%), decompression only 3 cases (30.0%).
6) The postoperative complications developed in 13 cases (30.2%) and the postoperative complication according to operative procedure in left colon developed 3cases (27.3%) in primary resection, 1 cases (17.6%) in staged operation, 2 cases
(50.0%)
in
decompression only.
7) The postoperative mortality was 9.4% and the causes of death were pulmonary complication 2 cases (4.7%), sepsis 1 case (2.3%), acute renal failure 1 case (2.3%).
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