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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