Three Cases of Obstructive Colitis Associated with Colo-rectal Cancer

Tetsuro Matsuda, Shigenori Akagi¹⁾, Shinpachiro Nomi, Ikuya Fujiwara, Shogo Toda, Hiroshi Makino, Keisuke Nakaji, Kazuyo Naito, Yoshihiro Omori, Takahiro Oka²⁾

1) Department of Surgery, National Insurance Kumihama Hospital
2) Department of Surgery, Kyoto Prefectural Yosanoumi Hospital

We experienced three cases of obstructive colitis associated with advanced carcinoma, which are presented with a review of the literature. Case 1: A 65-year-old-man with rectal obstruction due to type-2 cancer was operated on. A circular ulcer 20 cm in length had penetrated the normal mucosa 33 cm proximal to the obstruction. Case 2: A 58-year-old-woman was diagnosed as having a sigmoidal cancer with obstructive colitis, and a left extended hemicolectomy was carried out. A shallow ulcer 33 cm in length with a granular surface and edema was found 12 cm proximal to type-2 cancer. Case 3: A 58-year-old-woman was also operated on under the preoperative diagnosis of obstructive colitis secondary to a sigmoidal cancer. A broad lesion with a linear ulcer running longitudinally for 32 cm was found 7 cm proximal to type-2 cancer. The intervening mucosa was congested and pushed up by submucosal edema and hemorrhage. It is usually difficult to make an exact diagnosis of the condition prior to surgery because of the obstruction. Therefore, in case of a colectomy we should always be careful not to leave an associated lesion behind.

Key words
obstructive colitis, ischemic colitis

Reprint requests
Tetsuro Matsuda Department of Surgery, National Insurance Kumihama Hospital
161 Kumihama-cho, Kumano-gun, Kyoto, 629-34 JAPAN

Accepted
March 13, 1991

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