Colorectal carcinoma

Question 1

Which side of colon is more prone to CRC ?

Answer 1

Left side

Question 2

Risk factors

Answer 2

Non-modifiable
1)Age : >50 years old
2)Genetic : CRC syndromes , familial adenomatous polyposis , Lynch syndrome , Hereditary Non-Polyposis Colorectal Carcinoma (HNPCC)

Modifiable
1)Diet - low fibre intake
2)Lifestyle - alcohol consumption ,smoking ,obesity (these three can alter gut microbiome)
3)Past history : cholecystectomy , history of colon cancer , and ovarian or uterine cancer , inflammatory bowel disease

Question 3

Differentiate between right sided and left sided lesion

Answer 3

Right sided
-ulcerative type -> prone to bleeding chronically -> melena
-fecal matter is liquid in nature ( little or late obstruction)

Left sided
-annular type -> rectal bleeding
fecal matter is solid in nature ( obstructive symptoms)
-altered bowel habit
colicky ,dull aching pain

due to bleeding :
ASK FOR SYMPTOMS OF ANEMIA
-Body weakness
-palpitation
-shortness of breath
-chest discomfort

Question 4

Laboratory investigation

Answer 4

1)Full Blood Count
-to check for haemoglobin level in case of anemia
2)BUSE
-to look for electrolyte imbalances seen in intestinal obstruction
3)Liver function test
-liver function can deranged due to liver metastases

Question 5

Imaging investigation

Answer 5

Colonoscopy
-to tule out synchronous tumour
CT abdomen / Pelvis / thorax
-to investigate the spread of tumor

Question 6

Complication

Answer 6

1)Local complication
-intestinal obstruction
-bleeding
2)Systemic condition
-metastasis
-malnutrition
-liver failure