A 58-year-old man was referred to our hospital for reversion of his colon. He had
undergone colectomy of sigmoid colon cancer and creation of a colostomy 2 years earlier,
followed by repeated chemotherapies. Colonoscopy detected a 4 × 3 cm laterally spreading
tumor 2.5 cm from the anus (A). The rectum had mild stenosis, diffuse hyperemia, and spontaneous bleeding, consistent
with rectal disuse atrophy. To recover bowel function, we prescribed 2 weeks of saline-preserving
enema. An anal tube 5 mm in diameter and 10 cm in length was inserted into the rectum,
and 50 to 100 mL saline was injected through the tube twice a day. A total of 10 to
20 minutes was needed each time. Colonoscopy after 2 weeks confirmed significant alleviation
of his rectal disuse atrophy (B). Subsequently, endoscopic submucosal dissection was performed to completely resect
the lesion (C). Pathologic examination confirmed a villous adenoma with negative margins. The patient
recovered uneventfully and was discharged after 5 days. Reversion of his colon was
performed 3 months later. During 1 year of follow-up care, the patient was well, and
no tumor recurrence was noted (D).
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Article info
Publication history
Published online: September 21, 2022
Mohamed O. Othman, MD, Associate Editor for Focal PointsFootnotes
Supported by Chengdu Science and Technology Program (Grant No. 2021-YF05-00230-SN).
Liansong Ye, Tingfa Peng, and Lijuan Deng are co-first authors.
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© 2022 by the American Society for Gastrointestinal Endoscopy
