Current Surgical Diagnosis & Treatmetnt, 12th Edition, Ch. 30.
1. Discuss the risk factors for colorectal cancer.
2. Identify the common symptoms of colorectal cancer.
3. Discuss the evaluation and treatment of colorectal cancer.
4. Discuss the role of radiotherapy and chemotherapy in management of patients with
5. Using TNM classification, discuss the staging and five-year survival of colorectal
6. Describe the clinical findings of diverticular disease, differentiating the symptoms
and signs of uncomplicated and complicated diverticulitis.
7. Discuss non-operative management of diverticular disease.
8. Discuss operative therapy for diverticular disease i.e. uncomplicated and complicated.
9. Differentiate ulcerative colitis and Crohn’s disease of the colon in terms of history, x-
ray findings, prognosis and risk of cancer.
1. A 67-year-old white male presents to you with guaiac positive stools. An air contrast
barium enema study reveals a polyp at the splenic flexure. Discuss appropriate
management. Discuss the association between polyp size and risk of carcinoma.
2. A 69-year-old white male presents with a 6 cm carcinoma of the sigmoid colon and
obstructive symptoms. Work-up reveals widespread metastatic disease in both lungs
and the right lobe of the liver.
3. A 64-year-old white male presents with a complaint of passing air in his urine.
Discuss further evaluation and therapy options.
4. A 79-year-old white female with a long history of diverticular disease presents to the
emergency room with an acute abdomen. Emergency surgical exploration reveals a
free perforation of a sigmoid diverticular abscess with fecal spillage. Discuss
5. A 39-year-old white male with a four-year history of medically managed ulcerative
colitis presents with a sharp decrease in the number of stools. He is accustomed to
having three to four slightly bloody stools per day but has had no bowel movements
over the last three days. Physical exam reveals the patient to be obtunded, febrile
and with a distended tender abdomen. Abdominal series reveals the transverse colon
to be dilated to 10 cm. Discuss likely diagnosis and therapy options.
6. A 41-year-old white male with a three-year history of Crohn's disease presents with
his fourth episode of small bowel obstruction. An upper GI series reveals a string
sign in the mid ileum. Discuss further evaluation and therapy options.