Complication of Colorectal Cancer include intestinal obstruction, intestinal perforation, bleeding.
1, intestinal obstruction: the tumor may be caused by increased intestinal stenosis, intestinal contents through the obstacles, which led to mechanical intestinal obstruction. However, in clinical oncology acute intestinal obstruction due to tumor proliferation is not entirely due to intestinal obstruction, in many cases is caused by severe stenosis in the tumor on the basis of the inflammatory edema occurred, food is prepared to intestinal blockage or mannitol such as induced. Mainly for abdominal pain, abdominal distension, anal exhaust stop defecation, vomiting and so on. Terrier of colorectal cancer located in block 0% left colon, 20% ~ 30% in the right colon.
Pathological changes of intestinal obstruction:
intestinal swelling: the colon is the large population of bacteria, the volume of the gases produced by fermentation of a significant increase in pain caused by swallowing of gas also increased, gastrointestinal absorption fluid barriers, and ileocecal valve into the colon continuously. Obstruction of the proximal colon to the expansion of abdominal pressure increases, diaphragm to move, there circulating respiratory dysfunction.
loss of body fluids: for any reason there may be obstruction of the loss of liquid volume. Particularly in the emergence of strangulated intestine, the large number of fluid loss, severe dehydration, hemoconcentration, decreased blood volume, leading to shock.
electrolyte disorders: a large number of colorectal obstruction of intestinal secretion of fluid, plasma or blood loss, inevitably accompanied by loss of electrolytes, acid-base balance disorders, lead to severe electrolyte imbalance.
infection and sepsis: With the continuous development of obstruction, bowel wall thinning, increased permeability of intestinal necrosis or perforation of a large number of small-yin and toxins into the peritoneal cavity, caused by severe bacterial peritonitis and toxaemia , leading to toxic shock infection, multiple organ failure or even death.
The principles of treatment for intestinal obstruction due to colorectal cancer:
1 period curative measures: applied to the general situation is still good, the original tumor are still capable of radical resection.
2 period not curative measures: It should be emphasized to make tumor surgery operation in place 1, 2-stage operation is only the contents of the reconstruction of intestinal continuity, applicable to the general situation is still good, the primary tumor has radical However, removal of the opportunity to significantly unfavorable factors I phase match those.
measures to reduce the tumor burden: For the removal of primary tumors but not able to cure time, and should seek to remove the primary tumor, as appropriate, line I view intestinal anastomosis or ostomy.
measures to ease the symptoms: there is no tumor on time, and, where appropriate, line shunt (anastomosis) or intestinal ostomy to alleviate symptoms of intestinal obstruction.
2, intestinal perforation: a typical clinical manifestations of acute abdomen, abdominal tension and tenderness, X-ray Subphrenic see crescent-shaped game machines from the gas can be made a preliminary diagnosis. Common causes of perforation:
tumor caused by intestinal obstruction, perforation of the tumor site where the site more often than not, but due to obstruction of the proximal tumor.
ulcer and infiltration of the cancer type, there can be no obstruction, but due to the continuous tumor growth, Cancer Center, Department of Nutrition disorders, the occurrence of tissue necrosis, rupture, loss due to intestinal perforation. Early clinical perforation often high fever, the limitations of abdominal pain, high blood, abdominal mass, such as touch as the main performance, and not necessarily the performance of acute abdomen.
There is also a result of the growth of tumor infiltrating the surrounding organs such as the bladder, uterus, small intestine, the vagina produce adhesion, when the necrotic foci in the study, falling penetrate neighboring devices involved in the lawsuit and fistula formation. It is reported that colon cancer and the occurrence of fistula of colon cancer perforation of all Dacron 5% ~ 28%.
3, bleeding: Acute bleeding is a rare complication of cancer. Clinical short period of time once or repeated several times or a lot of fresh blood will be dark red, often exceeds the amount of bleeding for more than 1000ml, leading to faster heart rate, blood pressure decreased, liver cold shock, such as urine or even a series of symptoms, often life-threatening.
