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Ischemic proctitis 6 months after laparoscopic sigmoidectomy: a case report

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Title: Ischemic proctitis 6 months after laparoscopic sigmoidectomy: a case report
Authors: Yoshida, Takuto Browse this author
Ichikawa, Nobuki Browse this author →KAKEN DB
Homma, Shigenori Browse this author
Yoshida, Tadashi Browse this author
Emoto, Shin Browse this author
Miyaoka, Yoichi Browse this author
Matsui, Hiroki Browse this author
Taketomi, Akinobu Browse this author
Keywords: Ischemic proctitis
Ischemic colitis
Sigmoid colon cancer
Bloody stool
Laparoscopic sigmoidectomy
Non-surgical management
Hyperbaric oxygen therapy
Issue Date: 22-Feb-2021
Publisher: Springer
Journal Title: Surgical case reports
Volume: 7
Issue: 1
Start Page: 54
Publisher DOI: 10.1186/s40792-021-01133-7
PMID: 33616775
Abstract: Background Ischemic colitis is a common disease; however, its pathophysiology remains unclear, especially in ischemic proctitis after sigmoidectomy. We present a rare case of ischemic proctitis 6 months after laparoscopic sigmoidectomy. Case presentation The patient was a 60-year-old man with hypertension, type 2 diabetes, and hyperlipidemia. He was a smoker. He underwent laparoscopic sigmoidectomy for pathological stage I sigmoid colon cancer and was followed up without any adjuvant therapy. Six months after his surgery, he complained of lower abdominal discomfort, bloody stools, and tenesmus. Colonoscopy showed extensive rectal ulcers between the anastomotic site and the anal canal, which was particularly severe on the anal side several centimeters beyond the anastomosis. We provided non-surgical management, including hyperbaric oxygen therapy. The rectal ulcers had healed 48 days after the therapeutic intervention. He has not experienced any recurrence for 3.5 years. Conclusions While performing sigmoidectomy, it is important to consider the blood backflow from the anal side of the bowel carefully, especially for patients with risk factors of ischemic proctitis.
Type: article
Appears in Collections:医学院・医学研究院 (Graduate School of Medicine / Faculty of Medicine) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)

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