A case of panperitonitis caused by perforated extraperitoneal colostomy after laparoscopic abdomino-perineal resection for rectal cancer Yuya NAKAMURA 1 , Ryuji OKAMURA 1 , Hiroyuki NAKAYAMA 1 , Hironori KAWATA 1 , Tatsushi KATO 1 1Department of Surgery, Yamatotakada Municipal Hospital Keyword: 人工肛門造設 , 後腹膜経路 , 穿孔 pp.469-472
Published Date 2015/9/15
DOI https://doi.org/10.11477/mf.4426200165
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The patient was a 77-year-old man with diabetes, hypertension, and old myocardial infarction. He came to our hospital with acute abdomen and a diagnosis of panperitonitis caused by perforated bowel was made. Past medical history revealed that the patient had undergone laparoscopic abdomino-perineal resection for lower rectal cancer three months ago; sigmoid colostomy was created through the extraperitoneal route in order to prevent parastomal hernia. Emergency surgery was performed. During surgery, perforation at the edge of the extraperitoneal space was confirmed. We resected the perforated bowel and constructed transverse colostomy. The resected specimen revealed ulcer formation at the segment of abdominal wall and edge of the peritoneum. Pathological findings were compatible with ischemic colitis. The route for stoma creation is discussed with review of the literature.

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