[Adenocarcinoma in a closed rectal stump in inflammatory bowel disease]

We describe two cases of adenocarcinoma occurring in a closed rectal stump approximately 30 years after subtotal colectomy for ulcerative colitis, respectively, Cohn's disease. After many years disease-free, the patients presented with rectal secretions, including blood, and were diagnosed with metastasizing rectal cancer. Since malignant degeneration of a closed rectal stump may not give rise to symptoms until late in the disease process, it is suggested that the rectum should be controlled endoscopically every 2nd year following a subtotal colectomy for inflammatory bowel disease to enable radical surgery.