Adenocarcinoma of the colon is a rare diagnosis in pediatric patients. We present a previously healthy 15-year-old female who began experiencing escalating colicky abdominal pain and associated vomiting over 2 weeks in the setting of presumed acute gastroenteritis. A computed tomography scan revealed an obstruction in her descending colon. A multidisciplinary decision was made to perform a colonoscopy upon which a large, circumferential, friable lesion was discovered 40 cm from the anus. A colon decompression catheter was successfully inserted following controlled radial expansion (CRE) Balloon dilation to 13.5 mm beyond the mass, resulting in a significant discharge of fluid and gas. The patient underwent hemicolectomy with mass resection and colostomy. Biopsies confirmed poorly differentiated adenocarcinoma with "napkin-ring" morphology and positive lymph node metastasis with extranodal extension.
Keyphrases
- abdominal pain
- lymph node metastasis
- squamous cell carcinoma
- computed tomography
- locally advanced
- ultrasound guided
- papillary thyroid
- liver failure
- positron emission tomography
- magnetic resonance imaging
- minimally invasive
- respiratory failure
- drug induced
- rectal cancer
- radiation therapy
- decision making
- young adults
- intensive care unit
- ulcerative colitis
- quality improvement
- aortic dissection