A CASE OF ULCERATIVE COLITIS A RECTAL CANCER DEVELOPING 27 YEARS AFTER TOTAL COLECTOMY

Abstract

A 49-year-old woman was seen at the department because of melena. The patient had been followed on at ambulant basis since she underwent total colectomy and ileo-rectal anastomosis for total ulcerative colitis at the age of 22. Colonoscopy revealed a type 5 and protuberant lesion extending from the anal-canal into the rectum. The simultaneously performed biopsy led to a diagnosis of well differentiated adenocarcinoma, so that a residual rectal cancer after total colectomy was diagnosed. Abdomino-peritoneal resection of the rectum and ileostomy were performed patients with ulcerative colitis are at high risk for the development of cancerous lesions. In particular the development of residual rectal cancer after ileorectal anastomosis turned out to be a problem in America and Europe. In Japan only three cases, including this one, have been reported but the necessity for future follow-up studies after similar operations is suggested.