Bowel resection (Colostomy/Ileostomy)
Case Analysis Written Project
University of Texas at El Paso
NURS 3609 Family Situational Stressors
April 13, 2014
Cancer is a disease that affects everyone everywhere, rich and poor, black and white, brown and yellow, Mexican, American, Russian, and Singaporean, unbiased without preference. Cancer is a much studied and researched topic and although great advances in medicinal treatments through research have been discovered and developed, a cure has yet to be discovered. Cancer can affect any organ in the body and thus can present itself at anytime anywhere in our bodies. There are known substances (carcinogens) that place the general population at risk to develop cancer, however exposure to carcinogens and cancerous agents are not the only reason for cancer and tumor development.
Nearly all colorectal cancers that begin as adenomatous polyps are adenocarcinomas. Most tumors develop in the rectum and sigmoid colon, although any portion of the colon may be affected. The tumor typically grows undetected, producing few manifestations. By the time manifestations occur, the disease may have spread into deeper layers of the bowel tissue and adjacent organs. Colorectal cancer spreads by direct extension to involve the entire bowel circumference, the sub-mucosa, and outer bowel wall layers. Neighboring structures such as the liver, greater curvature of the stomach, duodenum, small intestine, pancreas, spleen genitourinary tract, and abdominal wall also may be involved in the direct extension. Metastasis to regional lymph nodes is the most common form of tumor spread. This is not always an orderly process; distal nodes may contain cancer cells while regional nodes remain normal. Cancerous cells from the primary tumor may spread by way of the lymphatic system or circulatory system to secondary sites such as the liver, lungs, brain, bones and kidneys. “Seeding” of the tumor to other areas of the peritoneal cavity can occur when the tumor extends through the serosa or during surgical resection (LeMone, 2011).
At the hospital where I did my Medical Surgical clinical rotation (University Medical Center), I was assigned to write a case analysis of a particular patient with these complications. The patient which I was instructed to conduct my case analysis was a 64-year old male who presented to the hospital ASU (Ambulatory Surgery Unit) with past surgical history of cholecystectomy and a laparoscopic converted to open sigmoidectomy and past medical history of epilepsy and sigmoid adenocarcinoma. The sigmoidectomy was successful and a colostomy bag was placed for fecal passage. The colostomy site became infected and necrotic, thus the physician advised the patient to treat the infection via a “colostomy takedown” and diversion to ileostomy. After the procedure was done, the above stated patient contracted Clostridium difficile, a bacterial disease causing symptoms such as diarrhea and...