Cancers of the descending and sigmoid colons may present with large bowelobstruction. Perforation is rare but may occur as a result of distention proximal to the tumor (usually in the cecum) or locally (at the site of the tumor) The primary tumor may be palpable in the abdomen. Overt rectal bleeding is more common in tumors of the sigmoid colon, whereas occult bleeding is typical with proximal tumors. A change in bowel habits may be the only presenting feature. Weight loss, jaundice, and ascites are associated with advanced metastatic disease.
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