20 February 2020 : Case report
A Rare Case of Prolapsed Sigmoid End Colostomy Complicated by Small Bowel Incarceration Treated with Manual Reduction and Emergency Surgery
Unusual clinical course, Diagnostic / therapeutic accidents, Management of emergency care, Educational Purpose (only if useful for a systematic review or synthesis)Kengo Kai12BDEF*, Takuto Ikeda2D, Koichiro Sano1D, Shuichiro Uchiyama1D, Hideto Sueta1D, Atsushi Nanashima2D
Am J Case Rep 2020; 21:e920431
BACKGROUND: Stoma prolapse is the full-thickness protrusion of bowel through a stoma, which occurs in 2% to 26% of colostomies. However, stoma prolapse complicated by small bowel incarceration is very rare, reported in only 3 cases thus far. To our knowledge, the present case is the first reported case of surgical treatment after preoperative manual reduction for small bowel incarceration.
CASE REPORT: A 74-year-old male who had undergone sigmoid end colostomy in the right lower abdomen by Hartmann’s operation for rectal cancer visited our emergency room complaining of severe stoma prolapse. The prolapse was about 20×15×15 cm in size and showed edematous change. Enhanced computed tomography revealed a loop of the small bowel incarcerated within the prolapsed colostomy. After the severe prolapse was reduced to 15×10×10 cm in size with manual compression for small bowel incarceration, an emergency laparotomy made via a circumferential incision revealed a partially necrotic prolapsed sigmoid colon and 15-cm-long reddish small bowel loop in the abdominal cavity that needed to be preserved. A new sigmoid end colostomy was constructed in the right lower abdomen at the same site as the preoperative stoma.
CONCLUSIONS: It is important to remember that small bowel can herniate into a stoma prolapse, and when encountering the acute presentation of a large stoma prolapse, manual reduction of the incarcerated small bowel may help in selecting elective versus emergency surgery.
Keywords: Colostomy, Emergency Treatment, Intestinal Volvulus, Aged, Colon, Sigmoid, Intestinal Obstruction, Laparotomy, Prolapse, Rectal Neoplasms
21 Sep 2023 : Case reportSuccessful Outpatient Treatment of Severe Diabetic-Foot Myositis and Osteomyelitis Caused by Extensively Dr...
Am J Case Rep In Press; DOI: 10.12659/AJCR.941337
21 Sep 2023 : Case reportFulminant Lymphocytic Myocarditis Successfully Managed with Intra-Aortic Balloon Pump and Extracorporeal Me...
Am J Case Rep In Press; DOI: 10.12659/AJCR.941422
21 Sep 2023 : Case reportEmphysematous Cystitis: A Rare Urologic Emergency
Am J Case Rep In Press; DOI: 10.12659/AJCR.941599
Most Viewed Current Articles
06 Dec 2021 : Case reportLipedema Can Be Treated Non-Surgically: A Report of 5 Cases
Am J Case Rep 2021; 22:e934406
07 Dec 2021 : Case reportEdwardsiella tarda: A Classic Presentation of a Rare Fatal Infection, with Possible New Background Risk Fac...
Am J Case Rep 2021; 22:e934347
13 Jul 2022 : Case reportWhistling Scrotum: An Unusual Presentation of Pneumomediastinum in the Setting of an Open Scrotal Wound
Am J Case Rep 2022; 23:e936441