A 45-year-old woman presented as an emergency with a 6-month history of large bowel obstruction. Symptoms Progressive constipation with a 3-week history of absolute constipation Abdominal distention Severe abdominal pain Family and medical history The patient was otherwise healthy and fit. There was no medical history. She was one of the identical triplets. Her younger sister was diagnosed with breast cancer at the age of 41, while the other was being investigated for colorectal malignancy.
Examination and investigations The patient did not show any signs of bleeding or intraluminal masses. There was a palpable, adnexal mass. WBCs: Elevated Arterial blood gas: Normal lactate Carcinoembryonic antigen: Elevated The plain chest radiograph did not show any free air under the diaphragm. CT scan revealed a thickened rectosigmoid wall in contact with a large complex pelvic mass arising from…
