J Acute Care Surg.  2023 Jul;13(2):74-77. 10.17479/jacs.2023.13.2.74.

Let’s Get That Bread Clip: Mechanical or Malignant Large Bowel Obstruction?

• Clark M
• Jones M
• Kong J

• KMID: 2544490
• DOI: http://doi.org/10.17479/jacs.2023.13.2.74

Abstract

A 60-year-old female presented with symptoms consistent with a large bowel obstruction (LBO). Following confirmation of LBO using imaging, she progressed to a laparotomy which potentially revealed a large rectosigmoid tumor with surrounding adhesions, deemed unresectable. The postoperative course was complicated by an enterocutaneous fistula. She was transferred to a tertiary center and underwent a repeat laparotomy which revealed a large fibrotic mass associated with an intra-luminal bread clip (expiry date 2002). This case report details the interesting causative nature of this LBO and the subsequent surgical management, and complicated postoperative course.

Keyword

enterocutaneous fistula, laparotomy, malignancy