A Case of Ischemic Colitis Due to Venous Stasis Occurring Half a Year after Laparoscopic Sigmoidectomy

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  • Tsuchiya Yasunori
    Department of Surgery, Imizu Municipal Hospital
  • Omura Tetsuya
    Department of Surgery, Imizu Municipal Hospital
  • Ota Nagayoshi
    Department of Surgery, Imizu Municipal Hospital
  • Hojo Shozo
    Department of Surgery and Science, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama
  • Matsui Koshi
    Department of Surgery and Science, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama
  • Yoshioka Isaku
    Department of Surgery and Science, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama
  • Okumura Tomoyuki
    Department of Surgery and Science, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama
  • Nagata Takuya
    Department of Surgery and Science, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama
  • Shimada Katsuo
    Department of Surgery, Imizu Municipal Hospital
  • Okada Eikichi
    Department of Pathology, TCMA (Toyama City Medical Association) Health Care Center
  • Fujii Tsutomu
    Department of Surgery and Science, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama

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Other Title
  • 腹腔鏡下S状結腸切除術半年後に発症し緊急手術を要した静脈うっ滞による虚血性腸炎の1例

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Abstract

<p>A 75-year old woman with a history of hypertension, hyperlipidemia and surgery for uterine myoma underwent laparoscopic sigmoidectomy and D3 lymph node dissection for sigmoid colon cancer. Constipation, anal discomfort, and clear drainage from the anus began 5 months after the operation, and a month later she visited our hospital. At 6 months after laparoscopic sigmoidectomy, CT revealed a severely thickened rectum from the anastomosis to the anus and dilatation of the internal iliac vein; and colonoscopy revealed severe erosion from the anastomosis to the anal side. Conservative treatment for about one month did not improve her symptoms and findings, and she then developed extensive anal bleeding and hypovolemic shock. Severe edema and fibrosis of the rectum and surrounding tissue were found in an emergency operation, and abdominoperineal resection was performed. Macroscopic findings of the resected specimen showed a severely thickened rectum wall. Histological findings showed dilated and meandering veins with congestion from the rectal submucosa to perirectal tissue. We suspected that this ischemic colitis was caused by venous stasis due to two pelvic surgeries.</p>

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