| Is Whole Colonic Imaging Necessary for Symptoms of Change in Bowel Habit and/or Rectal Bleeding? | |
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MedLine Citation:
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PMID: 22176613 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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Aim: Following introduction of 2 week-wait (2ww) cancer pathway many units are triaging patients with change in bowel habit (CIBH) and/or rectal bleeding (RB) straight to colonoscopy. Evidence suggests that right-sided colonic cancer does not present with these symptoms, hence imaging the left colon only is satisfactory. If this were substantiated, patients could be offered a flexible sigmoidoscopy (FS) alone. This study aimed to review presenting symptoms of patients diagnosed with a right-sided colonic malignancy and assess whether their tumours would be missed based on this practice. Method: This is a retrospective analysis of patients who underwent curative resection for a proximal colonic malignancy over a 4-year period. 2ww referral proforma and case notes were analysed for mode of presentation. Results: Of 206 elective right hemicolectomies performed, 20/206 (9.7%) patients presented in the absence of either iron deficiency anaemia or palpable abdominal mass. 12 patients had polyposis identified in the left colon and 8 patients had no left-sided colonic pathology. 1 patient had a strong family history of colon cancer (2 first degree relatives) in the group absent of left-sided pathology. Conclusion: 12 patients who had left sided polyposis and one patient with a strong family history would have undergone WCI based on current CRC management guidelines. The remaining seven patients with right-sided cancer would have been missed if FS were the only investigation used. Patients presenting on the 2ww with symptoms of a CIBH and or RB can be adequately investigated with a FS with a 3% chance of missing a proximal cancer. |
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Authors:
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Sarit Badiani; Anant Desai; Mark As Chapman |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2011-12-18 |
Journal Detail:
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Title: Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland Volume: - ISSN: 1463-1318 ISO Abbreviation: - Publication Date: 2011 Dec |
Date Detail:
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Created Date: 2011-12-19 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 100883611 Medline TA: Colorectal Dis Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Copyright Information:
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Copyright © 2011 The Association of Coloproctology of Great Britain and Ireland. |
Affiliation:
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Department of Colorectal Surgery, Heart of England NHS Foundation Trust, Birmingham, B9 5SS. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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