|Discussion in 'All Categories' started by Kulkarni Chandrashekhar - Jun 23rd, 2015 11:39 pm.|
|I had pain in abdomen on 15th August 2012 in the morning. My family doctor told pain might be due to Kidney Stone and advised to get admitted in the near by hospital. In the local hospital after checking Dr.surgeon told me I will have to undergo operation of both the Kidneys. Next day CT scan was done and before report Dr. started telling me there might be chances of 0.001 % cancer. The CT scan report reads as :
Clinical Diagnosis: Bleeding PR-CT-Lesion in sigmoid.
Diagnosis: Malignant Growth sigmoid colon.
CT scan Report:
1} Mild diffuse circumferential thickening of wall of sigmoid colon on right side extending for a length of approx 6.0 cms with adjacent pericolonic fat stranding.possibility of inflammatory/neoplastic etiology, former benign more likely. Colonoscopy and histopathological correlation is suggested.
2}Multiple small diverticuli in sigmoid and descending colon.
3}Bilateral inguinal hernia with herniation of omentum on right side and small part of sigmoid colon with omental fat on left side.
As per CT scan report suggested colonoscopy and histopathological correlation. So accordingly on 20 th august colonoscopy was done.
The report of colonoscopy is as: REPORT OF HISTOPATHOLOGICAL EXAMINATION
Dr's Clinical Diagnosis : Bleeding PR - CT - lession in sigmoid .
Sigmoid colon : growth seen in sigmoid 40 cm from anal verge circumferential Biopsies taken.
In view of inflammation & recent L/o obstructed r groin hernia - scope could not be negotiated beyond growth.
Diagnosis : ? malignent growth sigmoid colon.
REPORT OF HISTOPATHOLOGICAL EXAMINATION :Specimen : Biopsy from growth in sigmoid colon
Gross:Two tiny bits
microscopic features : Serial sections reveal :
- one colonic tissue bit with slight atypia of epithelium at the edge ;patchy increase in inflammatory cell population of lamina propria
second bit consists of fibrovascular tissue with mixed inflammatory infiltrate and conspicuous of eosinophils
Comment : Superficial biopsy : please collate the findings with endoscopic features.
OPERATION WAS DONE ON RD, REPORT RECEIVED ON 22nd August 2012.
REPORT ON HISTOPATHOLOGICAL EXAMINATION :
GROSS : Sigmoid colon ( 8.5 cm in length ) with circumferential thickening of the wall;c/s revealed,an ulcerated and indurated lesion ( 2 cm ) , 5 cm away from the cut margin. Rest of the mucosa and cut margins were normal,?one lymph node detected.
MICROSCOPIC FEATURES :Section reveal :
-foci of mucosal attention, denudation and ulceration; remnant of viable mucosa shows moderate dysplasia
- dense lymphoplasmacytic infiltrate with submucosal fibrosis :numerous large ectatic vessels in submucosa and muscularis mucosae
- no c/o granulomatous inflammation or frank neoplasia
- sections of remaining portion and cut margins ( sections A,Band C) are normal
-three tyny lymph nodes one of which shows sinus histiocytes
HISTOLOGICAL IMPRESSION : Non - specific ( probably ischemic
) colitis, moderate focal mucosal dysplasia and intramural angiodysplsia
COMMENT : Second opinion taken from senior pathologist Dr. F.P.Candes with concurrence of views.
Dr. i request you to give me legal opinion. Also please give me TOKEN to enable me to relate with my daily correspondence.
re: Operated on large intestine and removed sigmoid colon by Dr J S Chowhan - Jul 17th, 2015 2:35 pm
Dr J S Chowhan
|Dear Mr Kulkarni Chandrashekhar
After seeing all the reports and going through the post operative histopathology we have concluded that there was requirement of more conservative approach and medical management before surgery. The medicine has given nowadays the wide range of choices in colorectal health care problem, the physician should select the course best suited to the individual patient and the clinical situation presented.
When all the investigations are not available a recommendation for surgery was made in your case based on a consensus of experts.
Dr J S Chowhan
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