61/M A case of Infiltrating Moderately Differentiated Adenocarcinoma-Rectum upper 1/3rd Infiltrating visceral Peritoneum. LN status-14/14 nodes show reactive hyperplasia Staging-PT4aN0 K/C/O CAD Underwent CABG 10 years back Pt. had severe bleeding episode on POD 2. Stopped Aspirin,Clopilet Last bleeding episode 36 hours back PRBC transfusion done Hb @ present-10.2 from 7.9 Vitals Stable PT-12.8/INR-1.08/APTT-39.3/BT-2'30"/ CT -4'20" Pt. awaiting Chemotherapy Please suggest further line of treatment 🙏

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Surgery +Chemotherapy +Radiotherapy Consult medical as well as surgical oncologist

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Chemotherapy➡️CECT/PET scan ➡️restaging⬇️ Surgery LAR

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Surgery. Chemo. Radiation

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AC.NITRIC 30 C ONCE AND WAIT

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Petscan Opinion of oncologist Chemo Riodiotherapy

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