A Case of Colostomy Prolapse with Incarceration Treated with the Modified Altemeier Method

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  • Altemeier法を応用した人工肛門脱出嵌頓の1例

Abstract

<p>A 64-year-old female patient underwent construction of a double-barrel colostomy in the transverse colon due to an unresectable advanced sigmoid colon cancer in December 2017. Because she declined aggressive treatment, she was placed under observation without any intervention. In March 2018, she presented to our department with complaints of colostomy prolapse. Upon examination, the distal limb of the colostomy had prolapsed approximately 10 cm, exhibiting marked edema and rupture of the mucosa, with some areas showing necrosis. Laboratory tests at admission showed an inflammatory response. Contrast-enhanced CT of the abdomen revealed that the distal limb of the double-barrel colostomy was inverted and prolapsed. She was diagnosed with colostomy prolapse with incarceration and an emergency surgery was performed. Without laparotomy, the incarcerated necrotic intestine was resected and a single-layer anastomosis was performed. The operation time was 40 minutes, and the blood loss was little. The postoperative course was uneventful.</p>

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