PakarBedahAnda or Your-General-Surgeon is my blog in which I highlight common surgical problems faced by Malaysians. In the last 20 years of my practice, many of my patients presented with advanced diseases in which treatments were more complicated, and if they were cancers then the prognosis were poor. This is also my personal 'fight' against late presentation of surgical diseases particularly cancers.
Monday, October 18, 2010
SUDAH MUNTAH TAHI BARU NAK KOREK LUBANG..
Pepatah Melayu :
Sudah terantuk baru tengadah Hendak terberak baru nak gali lubang.
Inilah yang jadi kalau susah sangat nak faham
A 59 year old man, had fecal incontinence (tak boleh kontrol berak) two years ago. He went to a private hospital, told to have cancer of the rectum (usus besar dekat dubur) and adviced surgery. Refused, went to HUSM and told the same thing. Tak puas hati, went to Kota Bharu Hospital (HRPZII). Tak mahu faham juga.
He has cancer of the rectum, very close to the anus resulting in fecal incontinence (meaning the cancer has already involved the sphincter muscles). The surgery to the remove the cancer would also remove the sphincters. thus he would need a permanent colostomy.
Sebabkan tak mahukan colostomy, langsung tak mahu rawatan. Obviously, Tok Bomoh kata kolostomi tak perlu.
Two years sengsara pakai diapers. Now the cancer has totally oblitrated the rectum causing intestinal obstruction. Apa lagi, perut jadi kembung, tak boleh berak. Makanan masuk ikut mulut, tahi pun keluar ikut jalan yang sama.
Gambar X-ray usus besar kembung tiga kali ganda
Terpaksalah buat emergency operation. Sekarang bukannya nak buang kanser yang telah merebak (inoperable), tapi nak selamatkan nyawa, supaya boleh makan.
Grossly distended large intestine.
Akhirnya kena buat juga kolostomi juga. Now dahselamat; dah boleh makan dan berak melalui kolostomi.
Tapi kansernya tetap di situ.
AlhamdulilLah sekarang baru nak kemoterapi dan radioterapi. Tapi apakan daya !!!