Abstract
A 30-year-old man, diagnosed as having total ulcerative colitis 11 years earlier, complained of abdominal fullness and anal bleeding from February 1991. He was admitted for treatment of an acute attack of ulcerative colitis. Roentgenological examination revealed complete obstruction of the sigmoid colon, however no elevated lesion had been detected by a barium enema eight month prior to this admission. After 5 days of intensive intravenous steroid therapy, and bleeding had improved, but the sigmoid colonic obstruction was unchanged. Laparotomy revealed sigmoid colonic cancer which was unresectable because of direct invasion to other sites of the large bowel and ileum and peritoneal dissemination (H0N3P3Si). He died of acute respiratory failure on the 47th postoperative day. A routine cancer surveillance program seemed to be of little benefit in this case from the retrospective view. Also some colonic cancers associated with ulcerative colitis may have a tendency to more rapid progression than the ordinary colonic cancer.
