A CASE OF TOTAL DUPLICATION OF THE LARGE BOWEL WITH RECTAL CANCER IN AN ADULT PACIENT

Abstract

This paper described a pacient whose ileum, cecum, colon, rectum, and anus wre doubling.
A 69-year-old man was admitted to the hospital because of anal bleeding. Colonofiberscopy revealed a rectal cancer 3.0×3.0 cm in size. Upon further examination, a second anus was found. During the surgery, a duplicated ileum, appendix, cecum, colon, rectum, and Meckel's diverticulum were seen. A post operative examination revealed a duplicated urinary bladder and urethra. Epispodia was also observed.
The rectal cancer was moderately differentiated adenocarcinoma (mp, INFβ, lyo, vo, Ho, and M(-)). A polyp in the main colon and two polyps in the accesory colon were observed, but none of these were malignant.
Angiography of the superior and inferior mesenteric vessels was performed. The splitting of the vessel between the main colon and the accessory colon did not occer at the trunk vessel, but rather at the peripheral vessels.
In Japan, there have been only three reported cases of total duplication of the large bowel. However, all of these involved children under two years of age. Our case appears the first adult case of total duplication of the large bowel in Japan.