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Large Mass Removed From Colon And Ovary. On Blood Transfusion. What Are The Upcoming Risk?

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Posted on Sat, 23 Feb 2013
Question: Following surgery for 85 yr old female (mom) who sustained removal of large mass from colon and ovary. Small intestines rebuilt from large intestine. Many transfusions during surgery and now 2 weeks later continuous transfusions (at least 3-4) to bring up hemoglobin count. What is symptomatic of such need to continuously replenish Hemoglobin in this situation and what are the prospective dangers and risk she might be facing?
Thanks XXXXXXX
doctor
Answered by Dr. Robert Galamaga (6 hours later)
Hello and thank you for sending your question.

Your question is a very good one and I work on providing you with some information and recommendations.

The most important information that I would like to obtain is what the actual mass that was removed represents. I assume that this was sent to a pathologist for examination so that we might know whether this mass is a colon cancer or old burying cancer or something else or possibly something benign.

At this point regarding transfusions it is necessary to make sure that there is no active bleeding. If there is no active bleeding it would be necessary to find out if the bone marrow is functioning appropriately. Blood tests should be performed including checking iron studies as well as bone marrow function. The particular bone marrow function test that I would like to see a result of is called reticulocyte count. This will help us to terminate the bone marrow is actually generating enough red blood cells.

It is not uncommon during a significant illness for the bone marrow to become somewhat sluggish and producing blood cells. In this sense I would expect the bone marrow to slowly recover in the anemia to improve. However, if there was some active bleeding going on this needs to be addressed.

In addition it would be a good idea for your doctor to have the pathologist look at the blood under the microscope to see if there are any abnormal cells. This will again help To determine if there is any underlying disease process which is causing a lower blood count.

Thank you again for sending your question. I hope you have found my response to be informative. If you have any specific additional concerns I would be happy to continue to discuss those with you.

Dr. Robert

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Robert Galamaga (25 minutes later)
The mass removed was tested and determined to be carcinoid cancer. 22 years ago she had colon cancer and part of colon removed. She received chemotherapy and several years later was told that the cancer had vanished. Otherwise, always in good health physically and mentally sharp. As I write she was just rused back to ICU for a racing heart following a blood tranfusion procedure to increase hemoglobin. Will look into the other areas you mentioned and see if I can provide info. Thanks
doctor
Answered by Dr. Robert Galamaga (17 hours later)
Thank you very much for the additional information.

Sometimes with transfusion the amount of volume in the blood can challenge the heart and this can put stress on the body. This might be why she was transferred to the intensive care unit. Warily there can be some allergic reactions that can occur as well. I think thatin the intensive care unit she will have closer monitoring which is good for right now.

I will wait to see if you have any additional reports for me to discuss with you.

Dr. Robert
Note: For further queries related to kidney problems Click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Dr. Robert Galamaga

Oncologist

Practicing since :2002

Answered : 2635 Questions

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Large Mass Removed From Colon And Ovary. On Blood Transfusion. What Are The Upcoming Risk?

Hello and thank you for sending your question.

Your question is a very good one and I work on providing you with some information and recommendations.

The most important information that I would like to obtain is what the actual mass that was removed represents. I assume that this was sent to a pathologist for examination so that we might know whether this mass is a colon cancer or old burying cancer or something else or possibly something benign.

At this point regarding transfusions it is necessary to make sure that there is no active bleeding. If there is no active bleeding it would be necessary to find out if the bone marrow is functioning appropriately. Blood tests should be performed including checking iron studies as well as bone marrow function. The particular bone marrow function test that I would like to see a result of is called reticulocyte count. This will help us to terminate the bone marrow is actually generating enough red blood cells.

It is not uncommon during a significant illness for the bone marrow to become somewhat sluggish and producing blood cells. In this sense I would expect the bone marrow to slowly recover in the anemia to improve. However, if there was some active bleeding going on this needs to be addressed.

In addition it would be a good idea for your doctor to have the pathologist look at the blood under the microscope to see if there are any abnormal cells. This will again help To determine if there is any underlying disease process which is causing a lower blood count.

Thank you again for sending your question. I hope you have found my response to be informative. If you have any specific additional concerns I would be happy to continue to discuss those with you.

Dr. Robert