PARTICULARITIES OF DIAGNOSIS AND TREATMENT IN A CASE OF SYNCHRONOUS COLORECTAL CANCER.

In literature, synchronous colorectal cancer refers to the simultaneous presence of two or more malignant lesions located along different segments of the large intestine or separated by at least 4 cm, detected either pre-, intraoperatively or after maximum 6 month since a surgery addressed to a colon tumor. The incidence of synchronous tumors is approximately 3,5% of all cases of colorectal carcinoma, while in others it reaches up to 8,4%. It is believed that this difference is mainly due to false negative results. The present paper presents the case of a 75-year-old patient, with a history of essential hypertension and type 2 insulin requiring diabetes who came to the emergency room accusing diffuse abdominal pain and bloating accompanied by the absence of intestinal transit for fecal matter over the past 6 days and an episode of vomiting. The results of the investigations correlated with the patient's symptomatology indicate the diagnosis of bowel obstruction. The exploratory laparotomy reveals an ulcero- vegetative, partially stenotic mass lesion in the sigmoid colon with a diameter of about 5/6 cm. A second ulcero-vegetative, stenotic mass was identified at the hepatic flexure of the colon with a diameter of approximately 8/7 cm. No metastatic lesions on the liver or in the abdominal cavity were noted. Right hemicolectomy with end-to-end ileotransverse-anastomosis and end-to-end colorectal anastomosis were performed. The present paper aims to expose the particular aspects in the diagnosis and treatment of bowel obstruction by synchronous tumors on a patient with abdominal symptomatology attenuated on the background of neurological complications of diabetes. [ABSTRACT FROM AUTHOR]