Laparoscopic coloproctostomy after proctosigmoidectomy with single barrel colostomy caused by barium peritonitis : Report of a case Sachiko MAEDA 1 , Masatsugu HIRAKI 1 , Jun NAKAMURA 1 , Yasuo KOGA 1 , Akinari NOMURA 1 , Hirokazu NOSHIRO 1 1Department of Surgery, Faculty of Medicine, Saga University Keyword: バリウム , 腹膜炎 , 腹腔鏡下手術 pp.931-936
Published Date 2018/11/15
DOI https://doi.org/10.11477/mf.4426200644
  • Abstract
  • Look Inside
  • Reference

 Barium peritonitis is a rare and life-threatening complication of gastrointestinal barium contrast studies, causing persistent inflammatory reaction and strong diffuse adhesions. We report a case of successful laparoscopic adhesiolysis followed by coloproctostomy after proctosigmoidectomy with single-barrel colostomy due to barium peritonitis. A 59-year-old man suffering from sudden lower abdominal pain after upper gastrointestinal barium contrast study was admitted to our hospital. The patient was diagnosed as having perforation of gastrointestinal tract with generalized peritonitis, septic shock and disseminated intravascular coagulation, and emergent laparotomy was performed. Operative findings showed generalized peritonits with barium and perforation of the upper rectum. Thus, proctosigmoidectomy with single-barrel colostomy was performed. Postoperative inflammatory reaction prolonged but gradually receded, and the patient was discharged 42 days after the operation. Re-operation of laparoscopic coloproctostomy was performed 96 days after the initial operation. Although severe inflammatory adhesion was observed after generalized peritonitis with barium, laparoscopic coloproctostomy was performed successfully due to minute laparoscopic adhesiolysis made possible by laparoscopically magnified view. This case suggests that laparoscopic surgery might be considered as one of the treatment options for patients with barium peritonitis.

Copyright © 2018, JAPAN SOCIETY FOR ENDOSCOPIC SURGERY All rights reserved.


電子版ISSN 2186-6643 印刷版ISSN 1344-6703 日本内視鏡外科学会