Advanced rectal cancer in a long-term Hartmann's pouch: a forgotten organ revisited
| Autor: | Iftikhar Ahmed, Ahmed M. Al Maksoud |
|---|---|
| Rok vydání: | 2016 |
| Předmět: |
Male
medicine.medical_specialty Hartmann's pouch Colon Colorectal cancer Locally advanced Rectum Adenocarcinoma digestive system Asymptomatic Article Diverticulitis Colonic 03 medical and health sciences Fatal Outcome Postoperative Complications 0302 clinical medicine Stoma (medicine) Colostomy medicine Humans Aged Rectal Neoplasms business.industry General Medicine medicine.disease digestive system diseases Surgery medicine.anatomical_structure 030220 oncology & carcinogenesis 030211 gastroenterology & hepatology Pouch medicine.symptom business |
| Zdroj: | BMJ Case Reports. :bcr2015213405 |
| ISSN: | 1757-790X |
| DOI: | 10.1136/bcr-2015-213405 |
| Popis: | Hartmann's procedure is widely performed as a first-stage operation in cases of left colon emergencies when a one stage management is judged to be unsafe. Forty per cent of patients with Hartmann's procedure never get their stoma reversed, ending with a permanent stoma. The distal excluded Hartmann's pouch is usually forgotten compared to the proximal functioning colon. A 70-year-old man with Hartmann's procedure carried out previously for complicated diverticular disease presented with bleeding per rectum. Invasive adenocarcinoma was confirmed on histology. Subsequent staging revealed a locally advanced rectal cancer. The tumour progressed despite a course of neoadjuvant chemoradiation. The general condition of the patient deteriorated with development of renal failure. The patient died a few weeks later. By reporting this case, we are revisiting the long forgotten Hartmann's pouch to highlight the potential pathologies in the distal stump and to emphasise that a distal stump should not be forgotten even in asymptomatic patients. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
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