70yr. Old, housewife, from Ibraheem pasha. , examined on 29th /Sep. /2006, was complaining of the left lower abdominal pain of one month duration.

The pain located in the left lower abdomen, of one month duration, moderate in severity, colicky in nature, acute in onset, not related to eating or defecation, more at night. Relieved by nothing and aggravated by meals . Not referred or radiate any where, neither propagated nor migrated. The patient thought

Associated with anorexia, lose of weight about 10kg in 3 months, vomiting (1-2times per a day, propulsive , few hours after the meal). the vomitus was large involume, yellowish in color, bitter in taste , niether contain blood nor food from previous day). She was passing black stool.

Family & social history:
married, moderate economic status, not smoker. G11 P6 A3 D2.

Gynecological history:

Past medical history: Vaccination; un known. Allergy; un known. History of chronic disease;

same complain for one month.

History of chronic drug intake;

no. Hospitalization;Haemorrhoidecto my, one year ago.

Vital sign:

PR 74b/min BP 150/80mmHg RR 20cycles/min Temp.37.6

Pre operative preparation
Liquid meal intake, Enema on afternoon before operation.


Perioperative Claforan vial 1g & Flagyl bottle 500mg iv infusion after induction of GA Mid line incision, a solid mass located in the lower part of sigmoid colon . With wide range of normal colon excised with end to end anastomosis.

Post operative

she was received chemotherapy and after four month's all secondaries in the liver disappeared.

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On 18th August 2007 She reported to have constipation, Investigated revealed Recurrence proximally


There was a mass of omentum attached to the caecum, which excised With eventfull postoperative period