A 67 years old male patient who was known to have chronic ulcerative colitis for 18 years was admitted with complaints of pain abdomen, distention and low grade fever of 2 days duration. A CECT abdomen revealed luminal narrowing at the sigmoid with proximal colonic dilatation and a collection in the pelvis with free air within it. In view a suspected perforation with possibility of a sigmoid malignancy he was taken up for emergency surgery.Intraoperatively he was found to have a mass lesion highly suspicious of mitosis in the sigmoid with a perforation proximally. A sigmoid colectomy with an end colostomy was done. The option of a total colectomy was discussed with the patient preoperatively as the entire colon was diseased due to long standing ulcerative colitis, however he refused the same. He had a slow but uneventful postoperative recovery.
Histopathology of the resected colon confirmed an adenocarcinoma of the colon.
