A Case of Rectal Cancer with Obstructive Colitis Induced Laxative

DOI
  • Kaida Shogo
    Department of Gastroenterology, Tokyo Dental College, Ichikawa General Hospital
  • Arahata Kyoko
    Department of Gastroenterology, Tokyo Dental College, Ichikawa General Hospital
  • Ito Asako
    Department of Gastroenterology, Tokyo Dental College, Ichikawa General Hospital
  • Takarabe Sakiko
    Department of Gastroenterology, Tokyo Dental College, Ichikawa General Hospital
  • Kimura Kayoko
    Department of Gastroenterology, Tokyo Dental College, Ichikawa General Hospital
  • Kishikawa Hiroshi
    Department of Gastroenterology, Tokyo Dental College, Ichikawa General Hospital
  • Nishida Jiro
    Department of Gastroenterology, Tokyo Dental College, Ichikawa General Hospital
  • Matsui Jyunichi
    Department of Surgery, Tokyo Dental College, Ichikawa General Hospital

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Other Title
  • 大腸内視鏡検査前処置の下剤（sodium picosulfate hydrate）により閉塞性大腸炎をきたした直腸癌の1例

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A 75-year-old woman was admitted to our hospital with severe abdominal pain and hypotension after ingesting a laxative to prepare for a colonoscopy. Emergency colonoscopy showed a sub-circular tumor in the rectum and dilation of colon with dark red discoloration was observed in the oral side of the tumor, based on which we diagnosed the patient as having obstructive colitis. Because of the poor general condition of the patient, we determined that emergency surgery would be difficult. Therefore, we tried decompression using a colorectal tube. Her general condition improved, however, emergency surgery was performed because perforation occurred on the 17th day. Intraoperatively, ulceroinflammatory lesions were observed reaching up to the ascending colon, so a total colectomy and ileostomy were performed. Not many reported cases of colorectal tube placement for this disease have appeared so far, and emergency surgery has been performed in many cases. In our case, we considered that there was a certain significance in the colorectal tube placement as a symptomatic treatment to wait for the recovery of the patient’s general condition. For patients in whom colonic stenosis is suspected, taking the occurrence of this disease into consideration, we should carefully think about administering colon-clearing laxatives.

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