A Case of Multiple Colon Cancers Presented with Iliac Symptoms After Stoma Creation

Abstract

An 80-year-old man was admitted our hospital with the chief complaint of abdominal pain. Abdominal CT showed a tumor each in the sigmoid colon and the rectum, and dilatation of the oral side of the sigmoid colon. We did not insert a transanal decompression tube because the rectal tumor also caused stenosis and the scope could not pass through the lesion. We performed an emergent colostomy and discharged the patient, with a plan for radical operation at a later date. However, the patient returned to the hospital with complaints of persistent stomachache and abdominal distention. CT revealed dilatation of the bowel segment between the sigmoid and rectal tumors. Colonoscopy revealed obstruction caused by the rectal cancer, and we inserted a transanal decompression tube. After achieving sufficient decompression of the bowel, we performed laparoscopic anterior resection. The patient was discharged 16 days after the operation. Reportedly, the incidence of multiple cancers is higher in the colorectum than in other organs; however, advanced colorectal cancers causing simultaneous occlusions are rare. Usually, a stoma decompresses the distended colon, but as our case illustrates, in the case of multiple cancers, attention should be paid to the tumor towards the anal side to prevent obstruction, or an early radical operation should be performed.