Colon Perforation
1. Pathological changes and the clinical manifestations

(1) acute peritonitis-piercing: the features of the tumor in the colon perforation and abdominal same, larger cracks, large colon into the abdominal contents logistics acute diffuse peritonitis, Clinically, patients with acute perforation in the former accompanied ranging from the low level of obstruction, pain, abdominal distention and stop defecation and precursor symptoms; Visibility asymmetric abdominal intestinal whole abdominal tenderness and muscle tension.

(2) subacute-piercing abscess: pathological perforation often occurred in the primary tumor site, and without colon obstruction exists. Because of the continual growth of tumors, cancer of the Nutrition Center obstacles, necrosis, Rupture, and peritoneal off the same. For small perforation, tumor proximal lumen without obstruction, mesocaval pressure is not high, the colon into the abdominal cavity and less relief, the surrounding tissue adhesion formation of localized abscess or inflammatory parcels mass. Clinical perforation in patients with acute abdomen often pre-clinical manifestations, such as intra-abdominal abscess formation, there will be limitations with abdominal pain, persistent high fever, elevated blood, abdominal tenderness obviously hit the mass.

(3) chronic perforation of the colon fistula: the growth of colon cancer infiltrating the surrounding tissue and adjacent organ involvement with the adhesion of the primary cancer tumor necrosis off. When penetrating perforation adjacent organ involvement, forming different types of colon fistula, a common clinical organs fistula for colon fistula ileum and colon fistula jejunum, colon and colorectal gastrointestinal fistulas duodenal fistula.

2. Treatment

(1) the treatment of acute peritonitis perforation: carcinoma of the colon perforation caused by peritonitis, perforation short time, three to four hours within a short time of the preoperative active preparations should be OK for tumor resection of the lesion and perforation. If critically ill patients with peritoneal after serious pollution or perforation with shock, not tolerance larger operation, will stage stoma, peritoneal drainage, secondary tumor resection anastomosis suitable.

(2) abscess formation perforated colon cancer treatment: right colon and proximal transverse colon perforation caused by the abscess to Stage I tumor resection and anastomosis is feasible, and the left distal transverse colon perforation of the colon abscess Hartman’s surgery should be the first choice, if the patient-poisoning symptoms. The first abscess drainage and secondary tumor resection and anastomosis suitable.

(3) cancer of the fistula treatment: for this type of perforation of the colon without acute clinical process generally do not have emergency surgery can be dealt with adequately in the preoperative preparation circumstances elective surgery for stage radical mastectomy or tumor resection.

(3) anorectal cancer of the digestive tract bleeding is one of the major causes bleeding, bleeding under the speed and clinical divided into three types, acute hemorrhage, bleeding dominant and recessive bleeding. Right anorectal cancer caused by the treatment of lower gastrointestinal bleeding, including two principles, one for bleeding control, the second is itself cause cancer treatment. According to the hemorrhagic type, and tumor patients generally, and other aspects of comprehensive consideration, as appropriate, individually or both balanced implementation.