Ann Coloproctol.  2020 Oct;36(5):349-352. 10.3393/ac.2020.06.11.2.

Early Postoperative Anastomotic Obstruction Due to an Intraluminal Blood Clot After Laparoscopic Anterior Resection: A Case Report

Affiliations
  • 1Department of Colorectal Surgery, Seoul Yang Hospital, Seoul, Korea
  • 2Division of Colorectal Surgery, Department of Surgery, Hanil General Hospital, Seoul, Korea
  • 3Division of Colorectal Surgery, Department of Surgery, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea
  • 4Division of Colon and Rectal Surgery, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea

Abstract

Early postoperative anastomotic obstruction after colorectal surgery rarely develops. Herein, we present a case of a 50-year-old healthy woman who had an early postoperative anastomotic obstruction which was revealed caused by a blood clot and successfully managed by endoscopic approach. The patient was discharged after laparoscopic anterior resection and visited the emergency department one day after because of abdominal pain. Computed tomography showed that the anastomosis site was obstructed with low-density material. Intraoperative endoscopy was performed under general anesthesia and blood clot filling the lumen were identified. As the scope was advanced to the blood clot with air inflation, the blood clot was evacuated. The anastomosis site could be obstructed by blot clot with mucous debris albeit it is a rare condition. An endoscopic approach seems to be the first option in the diagnosis and treatment of postoperative obstruction at the anastomosis site and it could prevent unnecessary laparotomy.

Keyword

Anastomosis; Intestinal obstruction; Blood clot; Endoscopy
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