Colonic Cancer in Occlusion: A Case Report of 70 Patients Experience of the Visceral Surgery Department at the Moulay Ismail Military Hospital in Meknes, Sidi Mohamed Ben Abdallah University in Fez

Abstract

Occlusive colon cancer is a serious condition, as it combines two very serious pathologies: cancer and acute intestinal obstruction. Colon cancer is a malignant proliferative neoformation developed at the expense of the colonic wall. Colonic obstruction is defined as the interruption of normal intestinal transit, and represents the mode of revelation in 8 to 29% of colon cancers. Occlusion is the most common complication of colonic cancer, either as a result of the disease or as it progresses, accounting for 15-30% of cases. Occluded colon cancer poses a twofold problem:  On the one hand, occlusion and its potential repercussions, particularly of a general or upstream intestinal nature.  On the other hand, it reveals a late diagnosis most often associated with a locally advanced or metastatic tumour. Our study concerns 70 cases of colonic cancer in occlusion diagnosed and treated in the visceral surgery department of the Moulay Ismail Military Hospital in Meknes, over 5 years from 01 January 2019 to 31 December 2023. The aims of our retrospective study are:  Evaluate the proportion of this complication that is indicative of colonic tumour pathology.  To review the range of surgical and non-surgical techniques available.  To establish guidelines for dealing with this type of complication in order to minimise morbidity and mortality. Our series includes 46 men and 24 women with a sex ratio of 1.9 aged between 35 and 86 years, who presented to the emergency department after an average delay of 07 days with extremes of 03 days and 08 days, with an occlusive syndrome (78.6%), sub-occlusive syndrome (21.4%), abdominal pain (95.7%), transit disorders (82.9%), vomiting (75.7%) and rectal bleeding (72.9%). The clinical examination revealed weight loss in 49 patients (70%); abdominal distension in all our patients (100%); and an empty rectal ampulla in all our patients (100%). All our patients underwent PSA, which revealed colonic NHA in 81.4% of cases, .......