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Synchronous Colon Carcinomas Leading to Emergency Surgery. Clinical Case and Literature Review

Atanas Batashki, Petar Uchikov, Atanas Petkov, Yana Kashilska, Sonam Dendup


Colorectal carcinoma (CRC) is one of the most common malignant pathologies. It is also a leading cause of mortality in both sexes. The term synchronous colon tumors refers to the presence of two or more separate cancers in different parts of the colon in a given patient.

The present study aims to examine the data from the world exchange on the subject and to present a clinical case of a patient who, before his hospitalization, had mild complaints such as disturbances in the tract and the act of defecation. Immediately after hospitalization for a colonoscopy examination, with no preparation, the patient suddenly developed an extensive picture of obturation ileus and, after a short preoperative preparation, he was operated on as an emergency.

Due to the rapid negative dynamics in the patient’s general condition, the following physical examination methods: biochemical blood analysis, complete blood count, and abdominal X-ray, were used to establish the diagnosis and make a decision on urgent surgical intervention. Two tumor formations were found intraoperatively, one on the cecum obturating the ileocecal valve, causing ileus and diffuse peritonitis, and a second smaller one located immediately after the hepatic flexure. Operative intervention included extended right hemicolectomy, ileostomy lavage, and abdominal drainage. The histological examination determined an adenocarcinoma.

In conclusion, we can confirm that synchronous colon tumors are a rare clinical finding. They often represent a challenge in surgical intervention due to the extended volume of resection, a combination of accompanying diseases, and the age of the patient require a differentiated approach in elderly patients.


synchronous colon tumors, colorectal carcinoma, emergency surgery, ileus

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About The Authors

Atanas Batashki
Department of Special Surgery, Faculty of Medicine, Medical University of Plovdiv, Bulgaria Medical Institute of the Ministry of Interior of Republic of Bulgaria, Sofia, Bulgaria

Petar Uchikov
Department of Special Surgery, Faculty of Medicine, Medical University of Plovdiv, Bulgaria

Atanas Petkov
Department of Special Surgery, Faculty of Medicine, Medical University of Plovdiv, Bulgaria

Yana Kashilska
Fifth Diagnostic and Consultation Center, Plovdiv, Bulgaria

Sonam Dendup
Student, Faculty of Medicine, Medical University of Plovdiv, Bulgaria

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