Familial adenomatous colorectal polyposis complicated by colonic obturation: a clinical case

Background. Colorectal obturation is a fairly rare complication in patients with colorectal polyposis. Case descriptions of colonic obturation with underlying familial adenomatous colorectal polyposis have not been reported to date in national and foreign literature.

Clinical Case Description. Patient G., female, 31 yo, was emergently admitted to a surgical unit with a preliminary diagnosis: acute intestinal obstruction, complaints of abdominal pain, nausea, vomiting, stool and gas outlet blockage, marked general weakness. Clinical and biochemical blood tests without peculiarities. Signs of intestinal obstruction in abdominal ultrasonic and X-ray examination. Obstructive right hemicolectomy performed as emergent surgery. Diagnosis: transverse colonic C-r T3NoMo, stage II, clinical group 2. Patient had routine fibrocolonoscopy in six months; polyps were revealed in all operated colon portions. APC genetic test was positive, total colectomy was decided with single-barrel ileostomy excretion on anterior abdominal wall. Definitive diagnosis: transverse colonic C-r T3NoMo, stage II, developed with underlying familial adenomatous colorectal polyposis, clinical group 2.

Conclusion. Diagnosis of familial adenomatous colorectal polyposis with acute intestinal obturation is challenging due to forced urgent surgical intervention and lack of time for a detailed deeper examination in avoidance of baleful consequences. The case reported demonstrates that clinical manifestations of familial adenomatous colorectal polyposis extend beyond the routine complaints of abdominal bloating, stool blockage and rectal bleeding towards a formidable complication of acute colonic obturation of polypoid genesis.

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