An Uncommon Presentation of Obstructive Colonic Cancer: An Extensive Ischemic Colitis

Obstructive colonic cancer is a common presentation of colonic cancer but extensive ischemic colitis proximal to an obstructive colonic cancer is an uncommon condition. It has been referred to by various terms in the literature such as obstructive colitis. A 59-year-old female presented with fever, abdominal pain and diarrhea. Abdominal CT revealed a short segment of circumferential bowel wall thickening at sigmoid colon with diffuse colonic wall thickening proximal to the lesion. Emergency surgery was performed, and intraoperative findings found a tumor located at sigmoid colon causing proximal colonic obstruction. The serosal surface of proximal colon appears normal but intraluminal appear black in color. The major vessels were patent. Total colectomy with side-to-end ileo-rectal anastomosis was performed. Obstructive colitis is a rare condition, and its etiology remains unclear. We report our case to share an experience and to review the literature to facilitate the recognition and proper management.