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Friday, 9 September 2016

An Unexpected Diagnosis And A Grave Outcome!

Few months back, a 39-year-old man was admitted to our unit with acute upper abdominal pain and difficulty in passing flatus. This was gradual and over 24 hours.
There was no rectal bleeding or melena.
He had no other upper gastrointestinal symptoms.
He was healthy before the onset of these symptom.
Past history was remarkable for non-specific abdominal pain, two years earlier, for which he underwent colonoscopy, and it was normal.
He has no significant family history of malignancy.
Examination showed pallor, and his abdomen was slightly distended and tender.
Lab studies confirmed iron deficiency anemia.
Serum amylase was normal.
X-Ray of the abdomen revealed distended large and small bowel.
Abdominal ultrasonography showed multiple hypo-echoic hepatic lesions suggestive of secondary deposits.

Colonoscopy findings were shocking!

Guess then check below

Colonoscopy was consistent with Familial Adenomatous Polyposis (FAP), i.e. a new mutation.
More than 50 polyps were seen up to splenic flexure where an obstructing malignant-looking growth was found.

Urgent surgery was made to relieve obstruction.

Unluckily, he passed away two hours after surgery from a massive pulmonary embolism.

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