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Year : 2020  |  Volume : 17  |  Issue : 1  |  Page : 46-49

Malignant perforation of sigmoid colon in long-standing ulcerative colitis

Department of Surgical Gastroenterology, Indraprastha Apollo Hospital, Delhi, India

Correspondence Address:
G K Adithya
Indraprastha Apollo Hospital, Sarita Vihar, Mathura Road, Delhi - 110 076
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/am.am_31_19

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Chronic ulcerative colitis (UC) is a risk factor for malignancy in long-term disease process. Obstruction, perforation, and hemorrhage are the possible emergency situations in colorectal malignancy. A 68-year-old male with chronic UC for 18 years with steroid-dependent disease (on 10 mg prednisolone daily) presented with acute pain abdomen with distention not passing stool or flatus for 2 days. The patient was diagnosed to have perforation of colon secondary to rectosigmoid malignancy. Following the adjuvant therapy, the patient denied any definitive surgery and opted to stay on a colorectal cancer surveillance program. At present, the patient's positron emission tomography/computed tomography shows pelvic, liver surface, and small bowel deposits, suggestive of recurrence or metastasis. This case report is discussed to emphasize the importance of aggressive surgical treatment in long-term steroid-dependent disease and poor prognosis of perforated malignancy irrespective of pathological staging.

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