Abstract
The patient was a 74-year-old woman who had developed ulcerative colitis of pancolitis and relapse-remitting type at age 46. As it was intractable, the patient underwent total colectomy and ileoproctostomy at age 57, 11 years after the onset, at another hospital. Thereafter, her course was uneventful, without requiring hospital visits. Seventeen years after the surgery, or at age 74, she was examined at the previous hospital with the major complaint of melena. Residual rectal cancer was pointed out and she was referred to our hospital. Rectal amputation was performed, and residual rectal cancer, moderately differentiated adenocarcinoma, Rb, pA, pN0 stageII, was diagnosed pathologically. High grade dysplasia was observed around the carcinoma, and it was judged to be p 53 positive, and colitic cancer was suspected. Ileoproctostomy is rarely performed for ulcerative colitis today because of the high risk of carcinogenesis. This case suggests that the postoperative surveillance is needed for patients who underwent a surgery in the past or at an advanced age, and we report it together with an academic discussion.
