03/20/2001
Four day history of blood in stool; Rectal exam: Within Normal Limits; Abd: Tender upper outer quadrant, no HSM, no LAD appreciated.
03/20/2001
CXR: Normal
CT Abdomen: Approx. 2.5 cm mass in the colon at approx. the splenic flexure, does not extend into peritoneum; no HSM evident; no LAD.
03/27/2001
Colonoscopy w/biopsy: Fungating tumor mass at 85 cm (splenic flexure), obvious adenocarcinoma, resection is warranted.
03/27/2001
LFTs: Normal
03/27/2001
Transverse and descending colon resection with anastomosis and regional LN dissection: Mass confined to colon; no HSM; 12 regional LNs removed.
04/06/2001
Colonoscopic biopsy: Adenocarcinoma
04/06/2001
Gross: Transverse colon, descending colon, 12 regional LNs
Micro: Mod diff colonic adenocarcinoma, 2.2 cm in size, extending through muscularis propria, into the serosa; all 12 LNs free of disease.