A. Pengertian
Kolostomi adalah pembukaan suatu bagian kolon ke permukaan abdomen untuk mengalihkan feses baik secara sementara atau permanen.
(Smith, 1986).
B. Etiologi
· Hereditas
· Masukan lemak
· Penyakit inflamasi usus
· Homo seksualitas
· Polip kolon
C. Patofisiologi
Penyelidikan terhadap penyebab karsinoma kolorektal telah mendorong penelitian tentang lemak hewan dalam diet, bakteri anaerob dari usus besar, dan kandungans erat dalam otot. Masing-masing factor ini sebagian dapat menjelaskan distribusi geografis penyakit. Aspek serat menarik perhatian, karena dengan meningkatkan bulk dalam diet akan menurunkan waktu transit dan juga waktu kontak anatara makanan dan usus.
Kira-kira 60% sampai dengan 70% karsinoma ini terjadi pada rektum, area rektosigmoid, atau kolonsigmoid. Tipe pertumbuhan tergantung pada area asal. Karsinoma di sisi kiri cenderung tumbuh mengitari usus, mengelilinginya dan menimbulkan masa bulk, polioid, dan berjamur. Mayoritas kanker ini adalah adenokarsinoma. Tipe lain menembus usus dan menyebabkan abses, peritonitis, invasi organ sekitarnya, atau perdarahan. Tumor0tumor ini cenderung tumbuh dengan lambat, dan tetap asimtomatik untuk periode waktu yang lama. metastasis dapat terjadi pada hepar, paru-paru, tulang atau sistem limfatik.
Manifestasi klinis tergantung pada lkasi tumor. Individu yang mengalami melena, diare, dan konstipasi; ini adalah manifestasi paling sering dari lesi kiri. Tumor sisi kanan menyebabkan kelemahan, malaise, dan penurunan berat badan. Nyeri jarang terjadi, dan juga dapat sebagai akibat dari kontraksi usus yang berhubungan dengan obstruksi kolon parsial atau keterlibatan saraf. Obstruksi usus mungkin tanda pertama dari penyakit. Metastasis sangat dapat diperkirakan, dengan invasi saluran limfatik, peritoneum, dan saluran vena yang membuat penyebaran.
Kanker kolon menimbulkan berbagai antigen tumor, antigen karsinoembrionik (CEA) yang paling baik diketahui. Kadar "normal" dari CEA kurang dari 2,5 ng/mL, tetapi kadar ini dapat meningkat pada penyakit inflamasi non-malignan, khususnya pada saluran gastrointestinal.
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