Tuesday, August 10, 2010


A 55 year old man came to me for treatment of 'piles (buasir)'. He complained of passing out blood and mucus (lendir) during defecation, and lately the feeling of incomplete defecation (rasa berak tak puas). He had been seeing several doctors in his hometown for these symptoms, and all of them treated him with hemorrhoidal medications. None of them did a rectal examination.
When I examined him, there was an ulcerating tumour in the lower third of the rectum extending into the anal canal.
This is how it looks from the inside of the rectum (on colonoscopy). Anybody could have feel it if he sticks his finger into the rectum, but nobody did it. And the cancer was missed !
Anyway, after confirming the diagnosis with a tissue biopsy, I proceeded with surgery to remove the rectum (including the anus) and constructed him a permanent colostomy. This is the picture of the resected specimen.

The cancer can be seen very close to the anal skin.

This is the problem. A patient comes with very obvious symptoms, no proper assessment or examination done, yet, oh, you have buasir ! and a cancer is missed again until it's too late.

Susah sangatkah nak buat rectal examination ?

1 comment:

armouris said...

info tentang buasir di SIHAT SELALU - Punca dan Rawatan Buasir