28th February 2025

A 46-year-old man presents to the emergency department with a two-day history of severe abdominal pain

A 46-year-old man presents to the emergency department with a two-day history of severe abdominal pain associated with forceful episodes of vomiting and three episodes of non-bloody diarrhoea. He reports weight loss over the last couple of months but unsure of the exact amount, however, his shirts are now loose fitting.

He mentioned that his father died at the age of 72 due to bowel cancer and that his older sister had some bowel polyps removed when she was 26.

On examination, temperature is 37.5°C, BP 110/70 mmHg and heart rate 100 bpm. There is generalised abdominal tenderness on deep palpation.

His blood results are given below:

Faecal occult blood is positive.

Colonoscopy reports innumerable polyps in the descending, transverse and ascending colon. In addition, a 9 x 6 cm mass with irregular edges is detected at the caecum.

Which of the following is the most likely underlying condition?

Select the SINGLE most appropriate option from the list below. Select ONE option only.