MR XY 82 years old gentleman admitted to HTAR with chief complaint of colicky abdominal pain at left lumbar region associated with swelling,abdominal distention,alteration in bowel habit alternating between diarrhea and constipation,for constipation,it was small amount of feces like pellet associated with straining and per rectal blood,able to pass flatus,also complaint of loss of appetite and significant loss of weight,no nausea and vomiting.the symptoms appear in 2 month and it persistent in nature.Beside that,the patient also experienced easy lethargy,reduce in effort tolerance,shortness of breath,orthopnea and paroxysmal nocturnal dyspnoea and bilateral leg swellng developed since 6months.other than that there is no significant past medical history and family history of malignancy.
physical examination find out there is significant loss of weigth,patient look lethargy,conjunctival pallor,and focusing on abdominal exaimination there is palpable mass over umbilical and left lumbar region,per rectal examination done and there is no finding.
Further investigation include full blood count figure out low haemoglobin level which is 5.2g/dL which can give answer for cardiac event and anemia,sigmoidoscopy and colonoscopy then conducted and there is a mass over transverse and descending colon and tissue biopsy result finding comfirm that is colorectal carcinoma
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