A Case of Strangulated Ileus of the Descending Colon Due to an Adherent Band

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  • 索状物による下行結腸絞扼性イレウスの1例

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A 76-year-old man with a history of appendectomy was treated with chemotherapy in the pulmonology department of our hospital for right lung cancer (carcinomatous pleurisy). He had abdominal pain, and CT examination showed ileus of the descending colon. We suspected an internal hernia and performed an emergency operation. The intraoperative findings revealed that an adherent band had strangulated the descending colon. There were no signs of ischemia, so only the band was resected. On day 4 post-surgery, the patient developed mild hypochondriac pain and left flank pain. Laboratory tests showed leukocytosis and elevated C-reactive protein (CRP) levels, and on day 6 post-surgery, CT examination showed perforation of the descending colon from which the strangulation had been previously removed, and gangrenous cholecystitis. We performed left hemicolectomy, transverse colostomy, intraperitoneal drainage, transverse colostomy and cholecystectomy, and the patient was discharged 49 days after reoperation. Strangulated ileus of the colon due to an adherent band is a rare case, and we report herein on such a case together with a review of the literature.

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