Colorectal cancer with blood in stool as the first symptom

Mr. Zhao, 56 years old, was admitted to the hospital due to "bloody stool for 3 months".

Medical history

The patient had blood in the stool without obvious cause 3 months ago, accompanied by a change in stool shape, which was irregular and thin. He had constipation and weak bowel movements, and abdominal pain that was progressively worsening. He was not accompanied by obvious weight loss, fatigue, low fever, or decreased appetite.

Physical examination

There was no enlargement of lymph nodes, no obvious abnormality of heart and lung, normal physiological reflexes, and no pathological reflexes. A mass was palpable during digital rectal examination, and the finger glove was stained with blood.

Testing

Blood routine: WBC 26.1*109/L, RBC 3.10*1012/L, Hb 80G/L, Neutrophil percentage 94.2%

Routine stool examination: visible blood in the stool, bright red in color and large in amount.

There were no obvious abnormalities in electrocardiogram and X-ray. Colonoscopy showed a pink mass that was brittle and easy to bleed.

Diagnosis and treatment

Based on the symptoms and signs, the preliminary diagnosis was colorectal cancer, and surgical resection was recommended.

The patient underwent surgery, and the tumor tissue was sent for pathological examination, which confirmed colorectal squamous cell carcinoma. The patient recovered well after the operation, with no blood in the stool, stool formation, and reduced abdominal pain. The patient requested to be discharged from the hospital one month later. There was no recurrence during the 2-year follow-up after discharge.

This patient is a common colorectal cancer that occurs at the end of the rectum. Colorectal cancer that occurs in the rectum accounts for more than half of colorectal cancers. The first symptom is blood in the stool, followed by changes in bowel patterns and abdominal pain. There is no lymph node or blood metastasis, so chemotherapy is not recommended after surgery. The effect of early radical surgery for colorectal cancer is good, and there has been no recurrence in the two-year follow-up.