Review Note

Last Update: 09/24/2023 09:13 AM

Current Deck: Non-Technical

New Card (Unpublished)

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Front

An 88 year old man with cognitive impairment is transferred from his high level care nursing home with 3 weeks of increasing abdominal pain and distension, and now 2 days of obstipation. He has a past history of multiple cardiac stents, congestive heart failure, and a recent MCA stroke. An AXR shows a sigmoid volvulus. He and his family consent to endoscopic decompression of the volvulus. On the flexisig you find a large sigmoid tumour, and a biopsy reveals colorectal adenocarcinoma. A subsequent CTAP demonstrates what appear to be multiple lever mets in several lobes. The consultant wants you to book this patient for an anterior resection and asks you to go and consent him and prepare him for surgery, You disagree with this management.

What would you do?

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