Abstract
A case of perforated obstructive colitis with synchronous multiple colorectal cancer is described. A 58-year-old male visited the hospital because of left lower abdominal pain and fever. Abdominal plain X-ray films revealed a dilatation of the colon and niveau. The patient was admitted under a diagnosis of intestinal obstruction. Colonoscopy revealed a carcinoma in the rectum about 15 cm from the anal verge. Due to obstruction of the colon by the tumor, it was impossible to observe proximal side of the tumor. An attempt was made to eliminate the obstruction by microwave coagulation under colonoscopy, and a large amount of stool was discharged. However, afterward there appeared to be perforation of the colon and emergency operation was performed. The operative findings revealed cancer lesions in the rectum (Ra) and sigmoid colon, severe inflammation in the ascending colon, and two perforations on the opposite side against the mesenterium in the ascending colon. These findings were considered to be perforated obstructive colitis associated with colorectal cancer. Right colectomy, ileostomy, ascending colostomy and peritoneal drainage were performed. Three months after the first operation, the lesions of carcinoma were resected. There have been no reports of obstructive colitis associated with multiple colorectal cancer, therefore, this is considered to be a valuable case.
