Notable Intestinal Obstruction Caused by Malignancy Originating from the Proximal Region of the Ascending Colon and the Caecum: A Case Study and Literature Review

• Victor Ikechukwu Canice Nwagbara

  Department of Surgery, University of Calabar and University of Calabar Teaching Hospital, Calabar, Nigeria

• John Adi Ashindoitiang

  Department of Surgery, University of Calabar and University of Calabar Teaching Hospital, Calabar, Nigeria

• Theophilus Ipeh Ugbem

  Department of Pathology, University of Calabar and University of Calabar Teaching Hospital, Calabar, Nigeria

• Joseph Stephen Ukam

  Department of Surgery, University of Calabar Teaching Hospital, Calabar, Nigeria

• Joseph Esien Kooffreh

  Department of Surgery, University of Calabar Teaching Hospital, Calabar, Nigeria

• Itunu Oluwadara Adekanye

  Department of Surgery, University of Calabar Teaching Hospital, Calabar, Nigeria

• Maurice Efana Asuquo

  Department of Surgery, University of Calabar and University of Calabar Teaching Hospital, Calabar, Nigeria

Intestinal obstruction is a significant medical condition marked by an impediment in the bowel’s capacity to eliminate waste. This condition is characterized by a blockage that hinders digestion and the regular expulsion of waste, which can be attributed to either functional or mechanical factors. A malignant bowel obstruction is frequently observed as a complication in advanced cancer cases, particularly those affecting the digestive tract. A 59 year old male presented with a one-month history characterized by infrequent bowel movements, abdominal distension and pain. Following a comprehensive clinical and imaging studies, a diagnosis of intestinal obstruction was established. The presence of a colonic tumour located in the proximal segment of the ascending colon and caecum, accompanied by a significantly dilated caecum displaying an incompetent ileo-caecal valve and a distended ileum, constituted the indication for a right hemicolectomy. The postoperative course was unremarkable. Ultimately, histopathological analysis confirmed a definitive diagnosis of colon adenocarcinoma. Colonic cancer situated in the proximal ascending colon and the adjacent caecum is uncommon and may manifest as an intestinal obstruction. In appropriate circumstances, right hemicolectomy is considered the preferred therapeutic approach. Early detection and intervention which can be enhanced through targeted screening, are advisable to avert the complications associated with advanced colonic tumours.

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