Background. Colorectal obturation is a fairly rare complication in patients with colorectal polyposis. Case descriptions of colonic obturation with underlying familial adenomatous colorectal polyposis have not been reported to date in national and foreign literature.Clinical Case Description. Patient G., female, 31 yo, was emergently admitted to a surgical unit with a preliminary diagnosis: acute intestinal obstruction, complaints of abdominal pain, nausea, vomiting, stool and gas outlet blockage, marked general weakness. Clinical and biochemical blood tests without peculiarities. Signs of intestinal obstruction in abdominal ultrasonic and X-ray examination. Obstructive right hemicolectomy performed as emergent surgery. Diagnosis: transverse colonic C-r T3NoMo, stage II, clinical group 2. Patient had routine fibrocolonoscopy in six months; polyps were revealed in all operated colon portions. APC genetic test was positive, total colectomy was decided with single-barrel ileostomy excretion on anterior abdominal wall. Definitive diagnosis: transverse colonic C-r T3NoMo, stage II, developed with underlying familial adenomatous colorectal polyposis, clinical group 2.Conclusion. Diagnosis of familial adenomatous colorectal polyposis with acute intestinal obturation is challenging due to forced urgent surgical intervention and lack of time for a detailed deeper examination in avoidance of baleful consequences. The case reported demonstrates that clinical manifestations of familial adenomatous colorectal polyposis extend beyond the routine complaints of abdominal bloating, stool blockage and rectal bleeding towards a formidable complication of acute colonic obturation of polypoid genesis.
Benign neoplasms of the colon, rectum, anus and anal canal are true neoplasia of the colon mucosa and are associated with a high risk of colorectal cancer (CC). The literature review analyzes epidemiology, risk factors, and modern methods of diagnosis and treatment, and describes priority minimally invasive interventions for benign colorectal tumors.
Familial adenomatous polyposis is one of the most difficult to diagnose diseases in medical practice, at an early stage, multiple colorectal adenomas are clinically most often not manifested in any way, and at a later stage they inevitably transform into colorectal cancer. Poor clinical manifestation rarely make it possible to establish a diagnosis before the onset of malignancy, so extraintestinal symptoms can be a lifeline in the diagnosis of this disease. Congenital retinal pigment epithelium hypertrophy is a benign tumor that develops from the retinal pigment epithelium and can occur both in an isolated form and in patients with familial adenomatous polyposis of the colon. Unfortunately, in the Russian-language clinical literature there are practically no scientific papers devoted to this problem. Clinical case of patient P., 35 years old, who was routinely admitted to the surgical unit with a diagnosis of familial adenomatous polyposis is presented. During the additional examination, multiple tumor-like lesions of the eyes were revealed according to the type of hypertrophy of the retinal pigment epithelium. From the anamnesis, it was found out that in 2017 the patient underwent a check-up by an ophthalmologist, where an early pathological condition was detected for the first time, but the doctor’s attention was not paid to this clinical manifestation, and the patient was not subsequently referred for a consultation with a coloproctologist with suspicion of familial adenomatous polyposis.
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