2018 Volume 38 Issue 6 Pages 1043-1046
A 84-year-old man was diagnosed as having sigmoid colon cancer after a colonoscopy performed a few days previously by a local doctor. He presented at our hospital emergency outpatient clinic with abdominal pain and vomiting. Tenderness and muscular defense were observed throughout his abdomen. His blood test results showed WBC 16,690/μL, and CRP 1.12mg/dL. Abdominal computed tomography showed osmotic wall fertilization and intestinal dilation in the oral side of the sigmoid colon. In addition, an irregular high absorption region extending from the tumor to the central side along the sigmoid colon artery was recognized, and it was considered to be local development of the tumor. Emergency laparotomy surgery was performed under the diagnosis of obstructive sigmoid colon cancer. We palpated the tumor in the sigmoid colon and continuous necrosis for 30 cm was present in the oral side of the intestinal tract. We resected the sigmoid colon containing the necrotic intestine and constructed a single-hole colostomy. In the excised specimen, a black color change in the oral side of the colon mucosa was observed with the tumor center as the boundary. There have been no reports of obstructive colon cancer in which local proliferation of the primary tumor was thought to contribute to intestinal necrosis. This is considered a valuable case and is reported herein with a discussion of the relevant literature.
