A 76-year-old man complained of frequent diarrhea and appetite loss. He had undergone colorectal surgery for descending colon cancer and received a follow-up without recurrence for approximately a year. Computed tomography revealed colon wall thickening from the descending colon to the rectum and enlarged para-aortic lymph nodes, leading us to suspect descending colon cancer recurrence. However, endoscopic findings suggested ischemic colitis from the anal side of the anastomotic site to the rectum. There were circumferential redness, edematous change, and ulcer with distensibility. As pathological findings indicated no malignancy, we diagnosed ischemic colitis. Symptoms did not improve despite conservative treatment ; thus, low anterior resection was performed. Patient recovered after surgery and pathological findings confirmed ischemic colitis. He was discharged and progressed without symptoms. Therefore, it is important to differentiate ischemic colitis when cancer recurrence is suspected after surgery.
