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Relationship between presenting symptoms and tumor location in colorectal cancer patients Ismida, Fitri Dewi; Maghfirah, Desi; Salam, Nurbahri L; Yusuf, Fauzi; Mulia, Vera Dewi; Purnomo, Avisena Gatot
Universa Medicina Vol. 43 No. 3 (2024)
Publisher : Faculty of Medicine, Universitas Trisakti

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18051/UnivMed.2024.v43.321-328

Abstract

BackgroundColorectal cancer (CRC) often shows symptoms at an advanced stage, causing delayed diagnosis and poorer prognosis. Initial symptoms, or chief complaints, are usually identified through patient history and can vary based on tumor location. This can help in establishing a diagnosis. This study aimed to determine the relationship between presenting symptoms and tumor location in CRC patients at Zainoel Abidin Regional General Hospital, Banda Aceh. Methods This cross-sectional study was conducted using secondary data from medical records (2019–2022) for 163 CRC patients. Information on symptoms of patients were collected from patient files: anemia, anorexia, diarrhea, constipation, abdominal pain, rectal bleeding, and palpable abdominal mass. Tumor locations were classified as right colon, left colon, rectum, and left colon plus rectum. Bivariate analysis was used to analyze the data. Results Of the 163 patients, 98 (58%) were aged e”50 years, 82 (50.3%) were male, and 99 (60.7%) had rectal tumors. The percentage of patients presenting with rectal bleeding was significantly higher in rectal cancers (47.47%) as compared with cancers in the left colon (28.57%) and left colon and rectal (33.33%) cancers (p=0.000). The percentage of patients presenting a palpable abdominal mass was significantly higher in right colon (31.58%) compared with left colon (4.76%) and rectal cancer (1.01%) (p=0.000). ConclusionsTumor location in the right colon is associated with palpable abdominal mass, while rectal location is associated with rectal bleeding in CRC patients. Familiarity with clinical symptoms of CRC could make patients more sensitive to undergo more frequent screening for cancer.
Successful Management of Early Postoperative Small Bowel Obstruction Using Steroid: A Case Report Luthfi, Muhammad; maghfirah, Desi; Yusuf, Fauzi; Abubakar, Azzaki; Syahrin, Alfi; Purnomo, Avisena Gatot
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 25, No 3 (2024): VOLUME 25, NUMBER 3, December, 2024
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/253202475-83

Abstract

Background: Early Postoperative Small Bowel Obstruction (EPSBO) is a primary factor contributing to death and morbidity after pelvic and abdominal surgery. Although it is frequently regarded as a surgical emergency, the most recent research indicates that non-operative management is always preferable unless there are complications.Case: A 53-year-old woman came with symptoms of small bowel obstruction and a history of hysterectomy three weeks earlier. The patient refused surgical intervention, so a conservative approach was taken. She was given methylprednisolone 500 mg/day in two doses daily for three consecutive days, in addition to nasogastric tube insertion and symptomatic therapy. After three days of follow-up, the patient showed symptoms improvement, and the abdominal X-Ray and CT Scan showed no abnormal findings.Discussion: The majority of Early Postoperative Small Bowel Obstruction (EPSBO) cases, according to the most recent research, may be managed without surgery. Additionally, due to their anti-inflammatory properties, some medications, like corticosteroids, have been found to be beneficial and effective for EPSBO. This is because they may help resolve the obstruction and lessen the edema and fibrin deposition associated with EPSBO following abdominal surgery.Conclusion: Conservative therapy with steroids appears promising due to its lower risk profile and greater patient comfort. However, the exact mechanism and its efficacy in treating EPSBO have yet to be fully concluded, so further research is still needed.