Gastric Obstruction as a Rare Complication Following Sigmoid Colostomy: A Case Report

Kazuhiro Yasuda, Kosuke Suzuki, Koichiro Tahara, Takashi Etoh, Shinichi Tsutsui, Hidefumi Higashi and Seigo Kitano*

Department of Surgery, Beppu Medical Center
Department of Surgery I, Oita University Faculty of Medicine*

We report a rare case of gastric obstruction that followed sigmoid colostomy and required reoperation. An 81-year-old woman with kyphosis who had undergone abdominoperineal resection of the rectum and end-sigmoid colostomy by the intraperitoneal approach for rectal cancer 5 months earlier was admitted for abdominal pain and projectile vomiting. Abdominal CT showed such marked dilatation of the stomach that it filled the abdominal cavity. There was no evidence of cancer recurrence or bowel obstruction. An upper gastrointestinal series revealed gastroptosis and that the gastric antrum was compressed by the sigmoid colostomy. Gastric obstruction secondary to sigmoid colostomy was diagnosed, and re-colostomy by the extraperitoneal approach was performed. The postoperative course was uneventful, and the gastric obstruction was eliminated. To our knowledge, this is the first report of late gastric obstruction due to sigmoid colostomy. Colostomy by the extraperitoneal approach should be considered in patients with gastroptosis or kyphosis.

Key words
stoma, colostomy, complication

Reprint requests
Kazuhiro Yasuda Department of Surgery, Beppu Medical Center
1473 Oaza-Uchikamado, Beppu, 874-0011 JAPAN

Accepted
June 22, 2005

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