Please explain this diagnosis

"complete mechanical intestinal obstruction secondary to annular mass, descending colon, probable malignant."

PS. I really need medical explanation regarding this one. this is for my case presentation.. If possible give me a schematic diagram on its pathophysiology. I know it's too much but man i really need it. thanks guys.uuu

Hi karen,

This is Dr. Sharath, from India. Yes the descending colon is the most common site site for a carcinoma in the large bowel. Of the various modalities of growth annular growth is very common. It takes about 2 years for a lesion to completely encircle the bowel wall ( As per the Text book of Surgery by Sabiston 17th edition). Initially the carcinoma arise in the mucosa and spread transmurally and circumferentially.

There are many causes like ischemic colitis etc which can cause strictures in any part of the bowel. Your diagnosis should be based on clinical criteria like age of the patient , Duration of the symptoms and Family history of similar disease and very important is the past medical history of the patient. Without these details its difficult to come to a conclusion. The gold standard investigation of choice in this situation will be a lower GI endoscopy probably a Sigmoidoscopy which helps in getting a tissue bit for biopsy. Furthur you need to evaluate the entire large bowel for identifying synchronous primaries. Hope this will solve some of your problems. Futher if u need any clarification in this regard do amil me at drsharathm@yahoo.com.l