Authors
Ehiagwina L. A., Tagar E., Kpolugbo J., Odion C., Ideiyenmin V. V.
Abstract
Background: Colorectal cancer is one of the most common malignancies among adults above 50 years old, but rare
in young adults. The diagnosis of colorectal is rarely entertained in young adults presenting with constipation or
features of mechanical acute intestinal obstruction. This results in delayed diagnosis and poor outcomes. Case
summary: A 22-year-old male presented to the emergency department of our hospital with a 5-day history of colicky
abdominal pain, progressive abdominal distension, bilious vomiting and absolute constipation. He had a 5-month
history of recurrent colicky abdominal pain, haematochezia and progressive weight loss. There was no known family
history of inflammatory bowel disease or malignancy. As part of his routine investigations, plain abdominal X-rays
were done and findings were in keeping with features of mechanical small bowel obstruction (Fig 1 & 2). The chest
x-ray was normal. Abdominopelvic computed tomography (CT) revealed features of an obstructing proximal
transverse colonic mass. He had an emergency laparotomy and a right hemicolectomy. The histology of the
specimen revealed mucinous adenocarcinoma in the transverse colon. To the authors' knowledge, this is a rare
disease that presented to our facility. Conclusion: Colonic cancer is thought to be rare in young adults as compared
to older patients. However, the incidence rates have increased in young adults over the past 20 years, often in sharp
contrast to rapid declines in older adults. This underscores its importance in this young age group.
in young adults. The diagnosis of colorectal is rarely entertained in young adults presenting with constipation or
features of mechanical acute intestinal obstruction. This results in delayed diagnosis and poor outcomes. Case
summary: A 22-year-old male presented to the emergency department of our hospital with a 5-day history of colicky
abdominal pain, progressive abdominal distension, bilious vomiting and absolute constipation. He had a 5-month
history of recurrent colicky abdominal pain, haematochezia and progressive weight loss. There was no known family
history of inflammatory bowel disease or malignancy. As part of his routine investigations, plain abdominal X-rays
were done and findings were in keeping with features of mechanical small bowel obstruction (Fig 1 & 2). The chest
x-ray was normal. Abdominopelvic computed tomography (CT) revealed features of an obstructing proximal
transverse colonic mass. He had an emergency laparotomy and a right hemicolectomy. The histology of the
specimen revealed mucinous adenocarcinoma in the transverse colon. To the authors' knowledge, this is a rare
disease that presented to our facility. Conclusion: Colonic cancer is thought to be rare in young adults as compared
to older patients. However, the incidence rates have increased in young adults over the past 20 years, often in sharp
contrast to rapid declines in older adults. This underscores its importance in this young age group.
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