No abstract

BackgroundSecondary metastasis to regional lymph nodes for adjacent bowel invaded by colorectal cancers (CRCs) has not been extensively reviewed. We herein present three such cases.Case presentationThe first case is a cancer involving the cecum and sigmoid colon, and its primary site could not be determined even by pathological evaluation. Nodal involvement was revealed both in the mesocolon of the cecum and sigmoid. The second and third cases are a sigmoid colon cancer invading the jejunum and an ascending colon cancer invading the jejunum, respectively. These patients harbored secondary metastases to lymph nodes draining from the invaded small bowel segments. In spite of complete resection, all three patients metachronously developed liver metastases or recurrent disseminated nodules in the pelvis and subsequently died.ConclusionsIn cases of CRC invading another bowel segment, bowel resection with regional lymphadenectomy for both involved segments should be considered to achieve complete resection. However, the radical surgery did not necessarily provide a long-term survival.

The MS status of primary colorectal cancer influenced the risk of postoperative colorectal neoplasms.

A 47‐year‐old male patient without a documented past medical history was referred to Sanno Hospital because of constipation and abdominal pain, which he had had for more than 5 years. Abdominal X‐ray and CT scan showed an enlarged ascending colon from the cecum to the transverse colon, without apparent mechanical obstruction. The patient was diagnosed with chronic idiopathic colonic pseudo‐obstruction, and because his symptoms were resistant to medication, surgical treatment was required. Laparoscopic subtotal colectomy was performed without any complications. Constipation was relieved, and the patient began defecating 2–3 times a day without medication. Pathological specimens showed that Meissner's plexus and Auerbach's plexus had decreased and that there were fewer ganglion cells—findings consistent with chronic idiopathic intestinal pseudo‐obstruction.