A Case Report of Bowel Obstruction with Intestinal Dissection

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  • 癒着による索状物により回腸の途絶・閉塞をきたした1例

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A 73-year-old man with a past surgical history of advanced sigmoid colon cancer was seen in a local clinic complaining of abdominal pain and vomiting. He was referred to our hospital under the diagnosis of bowel obstruction. Abdominal radiography and computed tomography showed swelling of the small intestine. Based upon these findings and the past surgical history, he was diagnosed as having bowel obstruction, and a long tube was inserted. Intestinal fluid from the long tube did not decrease and his condition did not improve. We performed surgery on the 7th day. Laparotomy showed a funicular structure or band strangulating the ileum about 30 cm orally from the ileocecal valve. When the band was released, the intestine was found transected without exposure of the intestinal mucous membrane. Resection of the ileum with end-to-end intestinal anastomosis was performed. The postoperative course was uneventful. This is an extremely rare case of bowel obstruction with intestinal dissection secondary to a funicular band. In this case intestinal dissection occurred due to strangulation crossing the part of intestinal tract by a band, not in the form of a closed loop.

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