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A 72-year-old man diagnosed with rectal adenocarcinoma underwent laparoscopic radical resection with prophylactic loop ileostomy in our department. Following the surgery, the patient completed four cycles of adjuvant chemotherapy with the XELOX regimen (capecitabine plus oxaliplatin) in accordance with the current treatment guidelines. During the scheduled stoma reversal procedure, intraoperative exploration revealed an unexpected finding of black discolouration of the liver surface ( figure 1).