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首页> 外文期刊>World Journal of Gastroenterology >Delayed ischemic gangrene change of distal limb despite optimal decompressed colostomy constructed in obstructed sigmoid colon cancer: A case report.
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Delayed ischemic gangrene change of distal limb despite optimal decompressed colostomy constructed in obstructed sigmoid colon cancer: A case report.

机译：尽管在梗阻的乙状结肠癌中构造了最佳减压结肠造口术，但远端肢体缺血性坏疽的延迟改变：一例。

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摘要

Creating blow-hole colostomy for decompression could provide a time-saving and efficient surgical procedure for a severely debilitated case with a completely obstructed colorectal cancer. Complications are reported as prolapse, retraction, and paracolostomal abscess. However, complication with an ischemic distal limb has not been reported. We report a case of critical intra-abdominal disease after decompressed colostomy for relieving malignant sigmoid colon obstruction; a potential fatal condition should be alerted. A 76-year-old male visited our emergency department for symptoms related to obstructed sigmoid colon tumor with foul-odor vomitus containing fecal-like materials. An emergent blow-hole colostomy proximal to an obstructed sigmoid lesion was created, and resolution of complete colon obstruction was pursued. Unfortunately, extensive abdominal painful distention with board-like abdomen and sudden onset of high fever with leukocytopenia developed subsequently. Such surgical abdomen rendered a secondary laparotomy with resection of the sigmoid tumor along with an ischemic colon segment located proximally up to the previously created colostomy. Eventually, the patient had an uneventful postoperative hospital stay. In the present article, we have described an emergent condition of sudden onset of distal limb ischemia after blow-hole colostomy and concluded that despite the decompressed colostomy would resolve acute malignant colon obstruction efficiently; impending ischemic bowel may progress with a possible irreversible peritonitis. Any patient, who undergoes a decompressed colostomy without resection of the obstructed lesion, should be monitored with leukocyte count and abdominal condition survey frequently.
机译：创建用于减压的气孔结肠造口术可以为严重瘫痪的大肠癌完全阻塞的患者提供省时，高效的手术程序。据报道并发症为脱垂，牵开和副结肠结肠脓肿。但是，尚无缺血性远端肢体并发症的报道。我们报告了减压结肠造口术缓解恶性乙状结肠梗阻后发生一例严重腹内疾病的病例。应警告潜在的致命状况。一名76岁的男性前往我们的急诊科就诊，发现与乙状结肠肿瘤梗阻有关，伴有恶臭的呕吐物，含有粪便样物质。在梗阻的乙状结肠病变附近形成了一种新兴的气孔结肠造口术，并寻求完全结肠梗阻的解决方法。不幸的是，随后出现了广泛的腹部疼痛并伴有板状腹部胀痛，并突然发作高热并伴有白细胞减少症。这种外科手术腹部切除了乙状结肠肿瘤并切除了乙状结肠肿瘤，并在缺血结肠的近段进行了结肠造口术。最终，患者在术后住院期间保持了平稳。在本文中，我们描述了气孔结肠造口术后远端肢体缺血突然发作的紧急情况，并得出结论，尽管减压结肠造口术可以有效解决急性恶性结肠梗阻。即将发生的缺血性肠病可能伴有不可逆的腹膜炎。任何接受减压结肠造口术而未切除梗阻性病变的患者，均应接受白细胞计数和腹部状况调查，以对其进行监测。

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