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Obstructing colorectal cancer — MCCQE Part 1 MCQ

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HardAbdominal PainObstructing colorectal cancerMCCQE Part 1

A 65-year-old man has large bowel obstruction. CT: apple-core lesion at the sigmoid colon. No perforation or peritonitis. Most appropriate management?

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Correct answer: A — Oncological resection (sigmoid colectomy) after endoscopic stenting or proximal diversion

Obstructing CRC without perforation/peritonitis: options include emergency resection or bridge-to-surgery endoscopic stenting followed by elective one-stage resection (higher primary anastomosis rate). Hartmann's if unstable.

Reference: Canadian Colorectal Surgery / CCO