Colorectal Carcinoma: Pathogenesis and clinical findings
Obstipation Nausea & vomiting
Tenesmus Rectal pain Hematochezia
Hydronephrosis (swelling of kidney)
↓ appetite
Local bleeding
Abdominal Abscess
Weight loss
Acute blood loss
Iron deficiency anemia
Classification of tumours/abnormal growths:
1. Adenoma–abenigntumorfromglandular structures
2. Carcinoma–cancerarisingfromtheepithelial tissue of the skin or the lining of internal organs
3. Sarcoma–cancerarisingfromconnectivetissue
Mechanical bowel Obstruction
Ribbon (thin) stool
In rectum
Mass effect
Tumor ↓ bowel lumencaliber
Backed up contents mayberegurgitated
Cancerinvadesrectal sphincters, muscles, vessels&nerves
Compressing ureters, urine backs up into kidney
Compressing stomach
Abdominal distension/pain Invades blood vessels
Inflammatory
Bowel Disease Smoking
Abdominal radiation
Tubular adenomas
(pre- cancerous polyps)
Obesity
Local growth of tumor
Cell line mutations
Idiopathic
Uncontrolled cell division in the colon and rectum
Hereditary syndromes
Colorectal Carcinoma
(Develops over time)
Outside bowel serosa
Bowel perforation
Bowel to bowel/local organ fistulisation
Host immune cells release cytokines to combat cancer
Bowel contents leak
Metabolic abnormalities, ↑energy use
Tumor Spread Mechanisms:
1. Hematogenous 2. Lymphatic
3. Contiguous
4. Transperitoneal
Tumor cells spread distally
Friable vessels supply tumor
Metastatic Disease
Vessels Rupture
Occult bleeding &
melena (black stools) depletes stores of iron
Authors:
Karly Nikkel
Reviewers:
Michael Blomfield
Tony Gu
Yan Yu*
Edwin Cheng*
* MD at time of publication
Tumors develop in liver, lungs, brain, peritoneum and lymph nodes
Hematochezia (passage of fresh blood in stool)
Slow, chronic blood loss
Legend:
Pathophysiology
Mechanism
Sign/Symptom/Lab Finding
Complications
Published August 25, 2019 on www.thecalgaryguide.com