Abstract
The case involved a 64-year-old woman who underwent right hemicolectomy + D3 dissection with reconstruction by mechanical end-to-side anastomosis using the circular stapler for ascending colon cancer. The histopathological diagnosis was ascending colon cancer, pType2, 5×6 cm, tub2, pSS, pN2 (7/33), ly1, v2, pH0, pM0, and pStage IIIb. Eight courses of adjuvant chemotherapy with capecitabine were carried out. The patient was admitted to the hospital because of severe anemia 20 months after the operation. Lower gastrointestinal endoscopy revealed normal anastomosis created at the previous operation, but an irregular elevating lesion was identified at the blind loop of the colon closed by the linear stapler. Recurrence to the blind loop was diagnosed and re-excision was done. A 4 cm-sized recurrent tumor was confirmed within the blind loop and the tumor had invaded and penetrated into a part of the ileum. Furthermore, lymph node metastasis at the small bowel mesentery was identified.
Since the surgical margin at the first operation was negative for cancer cells, the recurrence in this case might be caused by implantation. So far few reports on such blind loop recurrence have been reported. We herein present the case, together with some bibliographic comments.
