Features of left side Ca colon are

. Patient can have de novo multiple primary carcinomas in different pas of the colon at the same time, i.e. synchronous (5-10%), or can present with growth in different pas of the colon in different periods, i.e. metachronous (10-20%). Gross types: Annular, tubular, ulcerative, cauliflower like. Annular (stenosing) type: * It is more common on left side. * Here the growth spreads round the internal wall and so it often presents with intestinal obstruction. * Left sided growth presents with colicky pain, altered bowel habits (alternating constipation and diarrhoea), palpable lump, distension of abdomen due subacute/ chronic obstruction. Later may present like complete colonic obstruction. Tenesmus, with passage of blood and mucus, with alternate constipation and diarrhoea, is common. Bladder symptoms may warn colovesical fistula. ref:SRB&;s manual of surgery,ed 3,pg no 838