secondary anastomosis after sigmoid colon
resection for perforated diverticulitis (Hinchey Stage III and IV).
Total Total number of patients 29 Age (years) 74 (46-85) Gender, n, (%) Male 14 (48%) Female 15 (52%) Tumor size (mm) 28 (11-89) Tumor location, n (%) Cecum 4 (14%) Transverse colon 2 (7%) Sigmoid colon
6 (21%) Rectum 17 (59%) Macroscopic type, n, (%) Sessile 10 (34%) LST-G 12 (41%) LST-ng 7 (24%) Histology, n, (%) Low-grade adenoma 19 (66%) High-grade adenoma 5 (17%) Adenocarcinoma, sm1 3 (10%) Adenocarcinoma, >sm1 2 (7%) LGT-G: laterally spreading tumor-granular type; LST-NG: laterally spreading tumor-nongranular type; sm1: submucosal invasion <1000 [micro]m; >sm1: submucosal invasion >1000 [micro]m.
Volvulus of the sigmoid colon
. Ann Surg 1973;177:527-537.
When lesions involve the sigmoid colon
, we prefer utilizing shaving excision when possible to limit dissection of the retrorectal space and pelvic sidewall nerves.
Pronounced bands of peritoneum may also be found running from the proximal sigmoid colon
to the posterior abdominal wall thereby restricting its mobility.
Internal herniation of a loop of the ileum anteriorly along with Richter's hernia of the sigmoid colon
posteriorly through the same defect in the superior wall of the urinary bladder was found (Figure 2).
Emergency surgery is needed to treat gangrenous SV, and primary anastomosis or stoma is used together with the resection of the gangrenous sigmoid colon
The total abdominal augmentation computed tomography and total colorectal sputum angiography showed that the upper and middle rectum, descending colon, transverse colon, and ascending colon were dilated, the maximum diameter of the intestine was 23 cm, and the intestine was filled with feces, suggesting that the lower rectum and sigmoid colon
were narrow [Figure 1]a and [Figure 1]b.
Separating the mass from the sigmoid colon
was challenging (Figure 2).
Failure to pull out IUD strings on gynecological examination made us suspicious of translocated IUD and its ectopic placement in sigmoid colon
was confirmed on colonoscopy and a CT abdomen with contrast.
Ileosigmoid knotting (ISK) is an uncommon cause of bowel obstruction where a loop of ileum and a loop of sigmoid colon
form a knot.
Surgical exploration revealed that the sigmoid colon
had been split at the distal end and had been primarily closed at both the proximal and distal ends.