Abstract
A 74-year-old woman who had had anal bleeding at defecation since December 2012 presented to the Department of Gastroenterology in our hospital in March 2013. Colonoscopy revealed a type 2 tumor encircling three-fourths of the circumference of the rectosigmoid junction. An abdominal CT scan showed a fused kidney in the pelvic cavity. She was referred to our department for the purpose of surgery in May of the year. Crossed renal ectopia is believed to be a comparatively rare congenital anomaly of the kidney. Among crossed ectopic kidneys, the lump kidney is characterized by that the fused kidney is located in a portion where is lower than the normal location and is often associated with anomalies of the ureter and renal artery and vein. Accordingly anatomical understanding of locations of them is important in performing surgery for rectal cancer. This time we have experienced a case of rectal cancer associated with a lump kidney. Since the patient had undergone operations for gastric ulcer and for a myoma of the uterine, we employed anterior resection under laparotomy. Before the surgery, we used fusion images with 3D CT and other various images to understand locations of the intestine, ureter, and vessels, for that we could complete surgery without causing intraoperative complications such as injury of the ureter. The 3D-CT fusion imaging might be beneficial in performing surgery for rectal cancer associated with kidney anomalies.
