The patient with left-sided colonic carcinoma may be pale due to chronic blood loss and anaemia, and may show weight loss. The left supraclavicular lymph nodes may be enlarged.
The abdomen may be distended and the caecum palpable. The liver may be enlarged due to metastases.
Masses may be felt in the left iliac fossa which may be hard and indentable because of faeces above the tumour. They will be tender if there is surrounding inflammation, and will be dull to percussion, but the abdomen will feel normal on palpation if the mass is small and lying in the paravertebral gutter. A mass may be noted anteriorly on rectal examination if the tumour is down into the pelvis.
Hyperactive bowel sounds indicate chronic intestinal obstruction. During an attack of colic, loud high-pitched continuous gurglings are heard.
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