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Elderly woman with diarrhea containing lot of mucoid material. Despite of not eating, diarrhea has not increased. She has no other symptoms. Colonoscopy shows cauliflower like-mass in the sigmoid colon. Lab dx shows hypokalemia. This pt. suffers from what?
a.Peutz-Jeghers syndrome
b.Villous adenoma
c.Hamartomatous polyp
d.Carcinoid tumor
e.Colonic diverticulum
f.Signet-ring cell carcinoma
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sorry abt the que,,It is " Despite of not eating, diarrhea has not DECREASED. "
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i think E,carcinoid tumer vip
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b is the correct answer.
The pt's lesion is consistent with villous adenoma. Although most of the colon adenomas are asymptomatic, larger ones can cause a number of symptoms:
1. Lower intestinal bleeding, guaiac positive stool and microcytic hypochromic anemia
2. Partial intestinal obstruction with changes in bowel habits, crampy abdominal pain, constipation and abdominal distension
3. Villous adenoma may also secrete large amt of mucus ----causing secretory diarrhea
If the stool volume is large, it may also cause hypovolemia and hypokalemia
4. Villous adenomas have a high risk of developing to adenocarcinoma
