1 Nov 2007Case Report
Rare complication after anterior resection of the rectum and colon reconstruction: severe constipation with obstructed defecation. Report of a Case
Salvatore Franco 1Gaspare Foresta 1Vittorio Lombardo 1Giorgio Giannone 1
Affiliations
Article Info
1 Department of Surgical Oncology, “Garibaldi” Hospital, Catania, Italy
Ann. Ital. Chir., 2007, 78(6), 525-527;
Published: 1 Nov 2007
Copyright © 2007 Annali Italiani di Chirurgia
This work is licensed under a Creative Commons Attribution 4.0 International License.
Abstract
OBJECTIVE: The aim of this manuscript is to verify the impact that some recanalization procedures for intestinal continuity could have in bowel function and quality of life. STUDY MATERIAL: We describe a clinical case of a rectal cancer patient who underwent anterior resection of the rectum with colo-anal anastomosis, coloplasty and diverting ileostomy. RESULTS: After the diverting ileostomy closure, suffered of severe bowel function problems. The establishment of a coloplasty caused a syndrome of such severe obstructed defecation to necessitate the reestablishment of a diverting ileostomy. DISCUSSION: Anterior resection with total mesorectal excision and colo-anal anastomosis is the gold standard surgical treatment of rectal carcinoma. The so called “anterior resection syndrome” is well known after such surgical procedures. The establishment of a reservoir such as the J-pouch and more recently the transverse pouch (coloplasty) are procedures used to improve the quality of life after anterior resection of the rectum. CONCLUSIONS: The presence of bowel obstruction without mechanical causes makes us consider the coloplasty as its cause with a Hirschprung like mechanism or similar to the “obstructed defecation”. The peristalsis stops at the coloplasty level impeding the progression of feces. The coloplasty or the pouch do not function as a reservoir to accommodate feces, but because they stop the peristalsis.
Keywords
- Anterior resection of the rectum
- Anterior resection syndrome
- Obstructed defecation