Abstract
Occlusion, perforation, and bleeding are a common presentation of colorectal cancer in the acute setting and are a challenging matter in terms of diagnosis, life-saving strategies, and oncological issues. The challenge is to combine the oncological skills and the acute care surgery expertise (in the urgent surgical theater).
The aim is to underline the clinical presentation, the diagnosis, and the treatment of colorectal cancer in emergency settings.
This is a preview of subscription content, log in via an institution.
Buying options
Tax calculation will be finalised at checkout
Purchases are for personal use only
Learn about institutional subscriptionsAbbreviations
- CRC:
-
Colorectal cancer
- CT scan:
-
Computed tomography
- DC:
-
Damage control
- HP:
-
Hartmann procedure
- LBO:
-
Large bowel obstruction
- LCO:
-
Left colon obstruction
- OLCC:
-
Obstructed left colon cancer
- ORCC:
-
Obstructed right colon cancer
- RC:
-
Right colectomy
- RPA:
-
Resection and primary anastomosis
- SEMS:
-
Self-expanding metallic stents
- TD:
-
Tube decompression
References
Arnold M, et al. Global patterns and trends in colorectal cancer incidence and mortality. Gut. 2017;66(4):683–91.
Torre LA, et al. Global cancer incidence and mortality rates and trends--an update. Cancer Epidemiol Biomarkers Prev. 2016;25(1):16–27.
Zielinski MD, et al. Emergency management of perforated colon cancers: how aggressive should we be? J Gastrointest Surg. 2011;15(12):2232–8.
Alvarez JA, et al. Presentation, treatment, and multivariate analysis of risk factors for obstructive and perforative colorectal carcinoma. Am J Surg. 2005;190(3):376–82.
Gunnarsson H, et al. Emergency presentation of colon cancer is most frequent during summer. Colorectal Dis. 2011;13(6):663–8.
Barnett A, et al. Colorectal cancer emergencies. J Gastrointest Cancer. 2013;44(2):132–42.
Laine L, et al. Trends for incidence of hospitalization and death due to GI complications in the United States from 2001 to 2009. Am J Gastroenterol. 2012;107(8):1190–5. quiz 1196.
Pereira J, et al. Management of bleeding in patients with advanced cancer. Oncologist. 2004;9(5):561–70.
Frago R, et al. Current management of acute malignant large bowel obstruction: a systematic review. Am J Surg. 2014;207(1):127–38.
Biondo S, et al. Differences in patient postoperative and long-term outcomes between obstructive and perforated colonic cancer. Am J Surg. 2008;195(4):427–32.
Anwar MA, et al. Outcome of acutely perforated colorectal cancers: experience of a single district general hospital. Surg Oncol. 2006;15(2):91–6.
Markogiannakis H, et al. Acute mechanical bowel obstruction: clinical presentation, etiology, management and outcome. World J Gastroenterol. 2007;13(3):432–7.
Cappell MS, Batke M. Mechanical obstruction of the small bowel and colon. Med Clin North Am. 2008;92(3):575–97. viii.
Lopez-Kostner F, Hool GR, Lavery IC. Management and causes of acute large-bowel obstruction. Surg Clin North Am. 1997;77(6):1265–90.
Kahi CJ, Rex DK. Bowel obstruction and pseudo-obstruction. Gastroenterol Clin North Am. 2003;32(4):1229–47.
Marion Y, et al. The management of lower gastrointestinal bleeding. J Visc Surg. 2014;151(3):191–201.
Shelton BK. Intestinal obstruction. AACN Clin Issues. 1999;10(4):478–91.
Suri S, et al. Comparative evaluation of plain films, ultrasound and CT in the diagnosis of intestinal obstruction. Acta Radiol. 1999;40(4):422–8.
Frager D, et al. Prospective evaluation of colonic obstruction with computed tomography. Abdom Imaging. 1998;23(2):141–6.
Finan PJ, Campbell S, et al. The management of malignant large bowel obstruction: ACPGBI position statement. Colorectal Dis. 2007;9(Supp 4):17.
Gainant A, et al. Emergency management of acute colonic cancer obstruction. J Visc Surg. 2012;149(1):e3–e10.
Chen SC, et al. Ultrasonography is superior to plain radiography in the diagnosis of pneumoperitoneum. Br J Surg. 2002;89(3):351–4.
Mularski RA, Sippel JM, Osborne ML. Pneumoperitoneum: a review of nonsurgical causes. Crit Care Med. 2000;28(7):2638–44.
Tang A, et al. Clinical cases of nonsurgical pneumoperitoneum: categorizing the disease and treatment options. Am Surg. 2015;81(5):E206–8.
Werner DJ, et al. Endoscopic and angiographic management of lower gastrointestinal bleeding: review of the published literature. United Eur Gastroenterol J. 2018;6(3):337–42.
Nusbaum S, Baum S. Radiographic demonstration of unknown sites of gastrointestinal bleeding. Surg Forum. 1963;14:374–5.
De Salvo GL, Gava C, Pucciarelli S, Lise M. Curative surgery for obstruction from primary left colorectal carcinoma: primary or staged resection? Cochrane Database Syst Rev. 2004;(2):CD002101.
Krstic S, et al. Hartmann’s procedure vs loop colostomy in the treatment of obstructive rectosigmoid cancer. World J Emerg Surg. 2014;9(1):52.
Fielding LP, Stewart-Brown S, Blesovsky L. Large-bowel obstruction caused by cancer: a prospective study. Br Med J. 1979;2(6189):515–7.
Kube R, et al. Surgical practices for malignant left colonic obstruction in Germany. Eur J Surg Oncol. 2010;36(1):65–71.
Trompetas V. Emergency management of malignant acute left-sided colonic obstruction. Ann R Coll Surg Engl. 2008;90(3):181–6.
Meyer F, et al. Emergency operation in carcinomas of the left colon: value of Hartmann’s procedure. Tech Coloproctol. 2004;8(Suppl 1):s226–9.
Alves A, et al. Postoperative mortality and morbidity in French patients undergoing colorectal surgery: results of a prospective multicenter study. Arch Surg. 2005;140(3):278–83. discussion 284.
Ballian N, et al. Comparable postoperative morbidity and mortality after laparoscopic and open emergent restorative colectomy: outcomes from the ACS NSQIP. World J Surg. 2012;36(10):2488–96.
Araki Y, et al. Endoscopic decompression procedure in acute obstructing colorectal cancer. Endoscopy. 2000;32(8):641–3.
Harris GJ, et al. The management of neoplastic colorectal obstruction with colonic endolumenal stenting devices. Am J Surg. 2001;181(6):499–506.
Zhang Y, et al. Self-expanding metallic stent as a bridge to surgery versus emergency surgery for obstructive colorectal cancer: a meta-analysis. Surg Endosc. 2012;26(1):110–9.
Cennamo V, et al. Does stent placement for advanced colon cancer increase the risk of perforation during bevacizumab-based therapy? Clin Gastroenterol Hepatol. 2009;7(11):1174–6.
Manes G, et al. Endoscopic palliation in patients with incurable malignant colorectal obstruction by means of self-expanding metal stent: analysis of results and predictors of outcomes in a large multicenter series. Arch Surg. 2011;146(10):1157–62.
Faucheron JL, et al. Emergency surgery for obstructing colonic cancer: a comparison between right-sided and left-sided lesions. Eur J Trauma Emerg Surg. 2018;44(1):71–7.
Chang GJ, et al. Practice parameters for the management of colon cancer. Dis Colon Rectum. 2012;55(8):831–43.
Amelung FJ, et al. Emergency resection versus bridge to surgery with stenting in patients with acute right-sided colonic obstruction: a systematic review focusing on mortality and morbidity rates. Int J Colorectal Dis. 2015;30(9):1147–55.
Mazuski JE, et al. The surgical infection society revised guidelines on the management of intra-abdominal infection. Surg Infect (Larchmt). 2017;18(1):1–76.
Sartelli M, et al. Management of intra-abdominal infections: recommendations by the WSES 2016 consensus conference. World J Emerg Surg. 2017;12:22.
Honore C, et al. Definition of patients presenting a high risk of developing peritoneal carcinomatosis after curative surgery for colorectal cancer: a systematic review. Ann Surg Oncol. 2013;20(1):183–92.
Strate LL, Gralnek IM. ACG clinical guideline: management of patients with acute lower gastrointestinal bleeding. Am J Gastroenterol. 2016;111(4):459–74.
Person B, et al. Abbreviated emergency laparotomy in the non-trauma setting. World J Emerg Surg. 2009;4:41.
Weber DG, Bendinelli C, Balogh ZJ. Damage control surgery for abdominal emergencies. Br J Surg. 2014;101(1):e109–18.
Becher RD, et al. Damage control operations in non-trauma patients: defining criteria for the staged rapid source control laparotomy in emergency general surgery. World J Emerg Surg. 2016;11:10.
Kaya E, et al. Predictor of poor outcome in gastrointestinal bleeding in emergency department. World J Gastroenterol. 2016;22(16):4219–25.
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2019 Springer Nature Switzerland AG
About this chapter
Cite this chapter
Picariello, E. et al. (2019). Emergencies Related to Primary Colon Cancer: Multidisciplinary Management of Colon Obstruction, Perforation and Bleeding Due to Colon Cancer in the Absence of Metastatic Disease. In: de'Angelis, N., Di Saverio, S., Brunetti, F. (eds) Emergency Surgical Management of Colorectal Cancer. Hot Topics in Acute Care Surgery and Trauma. Springer, Cham. https://doi.org/10.1007/978-3-030-06225-5_8
Download citation
DOI: https://doi.org/10.1007/978-3-030-06225-5_8
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-030-06224-8
Online ISBN: 978-3-030-06225-5
eBook Packages: MedicineMedicine (R0)