Chen Weihao, Teh Readon, Qurishi Absar
Division of Gastroenterology, Department of Medicine, Ng Teng Fong General Hospital Singapore.
Division of Gastroenterology and Hepatology, National University Hospital Singapore.
POCUS J. 2022 Nov 21;7(2):190-192. doi: 10.24908/pocus.v7i2.15657. eCollection 2022.
We present a case of a 64-year-old gentleman for whom point of care ultrasound (POCUS) expedited the diagnosis and subsequent early treatment of colon adenocarcinoma. He was referred by his primary provider to our clinic for abdominal bloating. He had no other abdominal symptoms such as abdominal pain, change in bowel habits or rectal bleeding. He had no constitutional symptoms such as weight loss. The patient's abdominal examination was also unremarkable. However, POCUS identified a 6 cm long hypoechoic circumscribed colon wall thickening around the hyperechoic pattern of bowel lumen (Pseudokidney sign)1 in the right upper quadrant, which suggested the presence of an ascending colon carcinoma. In view of this prompt bedside diagnosis, we organised a colonoscopy, staging computerised tomographic scan and colorectal surgery consultation the next day. After the locally advanced colorectal carcinoma was confirmed, the patient had curative surgery within 3 weeks of his presentation to the clinic.
我们报告一例64岁男性患者,其床旁即时超声(POCUS)加快了结肠腺癌的诊断及后续早期治疗。他由初级医疗服务提供者转诊至我们诊所,主诉腹胀。他没有腹痛、排便习惯改变或直肠出血等其他腹部症状。也没有体重减轻等全身症状。患者的腹部检查也无异常。然而,POCUS在上腹象限发现一段6厘米长的低回声、边界清晰的结肠壁增厚,围绕着高回声的肠腔(假肾征),提示升结肠癌的存在。鉴于这一迅速的床旁诊断,我们于次日安排了结肠镜检查、分期计算机断层扫描及结直肠外科会诊。在确诊为局部进展期结直肠癌后,患者在就诊于诊所后的3周内接受了根治性手术。