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Volvulus of the Sigmoid Colon Associated With Rectal Cancer: A Case Report

Sigmoid volvulus is one of the three most common causes of acute colonic obstruction. Predisposing factors include chronic constipation, adhesion from a prior abdominal surgery, and megacolon. However, concomitant presentation of volvulus of the sigmoid colon and rectal cancer is extremely rare. We...

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Detalles Bibliográficos
Autores principales: Lee, Seung-Hyun, Ahn, Byung-Kwon, Baek, Sung-Uhn
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elmer Press 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5051175/
https://www.ncbi.nlm.nih.gov/pubmed/27785289
http://dx.doi.org/10.14740/gr619w
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author Lee, Seung-Hyun
Ahn, Byung-Kwon
Baek, Sung-Uhn
author_facet Lee, Seung-Hyun
Ahn, Byung-Kwon
Baek, Sung-Uhn
author_sort Lee, Seung-Hyun
collection PubMed
description Sigmoid volvulus is one of the three most common causes of acute colonic obstruction. Predisposing factors include chronic constipation, adhesion from a prior abdominal surgery, and megacolon. However, concomitant presentation of volvulus of the sigmoid colon and rectal cancer is extremely rare. We report a case of a 50-year-old woman with coexisting volvulus of the sigmoid colon and rectal cancer. The patient presented with abdominal distension and pain for 2 days. On computed tomography, the whole colon was dilated with gas and feces. A whirl sign with rotation of the inferior mesenteric vessel was identified. The rectum had irregular wall thickening. Colonoscopy showed a circumscribed, ulcerofungating mass approximately 6 cm from the anal verge. The sigmoid colon was obstructed at a point approximately 25 cm from the anal verge. The mucosa was hyperemic and edematous with the pathognomonic spiral pattern. Endoscopic reduction was not successful. On laparotomy, the sigmoid colon was rotated around its mesentery. It was severely distended with edematous, hyperemic serosa. A tumor of the rectum was identified in the mid-rectum. The patient underwent low anterior resection and protective ileostomy. Pathologic findings confirmed adenocarcinoma of the rectum. The postoperative course was complicated by an ileus, which was managed with conservative treatment.
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spelling pubmed-50511752016-10-26 Volvulus of the Sigmoid Colon Associated With Rectal Cancer: A Case Report Lee, Seung-Hyun Ahn, Byung-Kwon Baek, Sung-Uhn Gastroenterology Res Case Report Sigmoid volvulus is one of the three most common causes of acute colonic obstruction. Predisposing factors include chronic constipation, adhesion from a prior abdominal surgery, and megacolon. However, concomitant presentation of volvulus of the sigmoid colon and rectal cancer is extremely rare. We report a case of a 50-year-old woman with coexisting volvulus of the sigmoid colon and rectal cancer. The patient presented with abdominal distension and pain for 2 days. On computed tomography, the whole colon was dilated with gas and feces. A whirl sign with rotation of the inferior mesenteric vessel was identified. The rectum had irregular wall thickening. Colonoscopy showed a circumscribed, ulcerofungating mass approximately 6 cm from the anal verge. The sigmoid colon was obstructed at a point approximately 25 cm from the anal verge. The mucosa was hyperemic and edematous with the pathognomonic spiral pattern. Endoscopic reduction was not successful. On laparotomy, the sigmoid colon was rotated around its mesentery. It was severely distended with edematous, hyperemic serosa. A tumor of the rectum was identified in the mid-rectum. The patient underwent low anterior resection and protective ileostomy. Pathologic findings confirmed adenocarcinoma of the rectum. The postoperative course was complicated by an ileus, which was managed with conservative treatment. Elmer Press 2015-02 2015-02-14 /pmc/articles/PMC5051175/ /pubmed/27785289 http://dx.doi.org/10.14740/gr619w Text en Copyright 2015, Lee et al. http://creativecommons.org/licenses/by/2.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Case Report
Lee, Seung-Hyun
Ahn, Byung-Kwon
Baek, Sung-Uhn
Volvulus of the Sigmoid Colon Associated With Rectal Cancer: A Case Report
title Volvulus of the Sigmoid Colon Associated With Rectal Cancer: A Case Report
title_full Volvulus of the Sigmoid Colon Associated With Rectal Cancer: A Case Report
title_fullStr Volvulus of the Sigmoid Colon Associated With Rectal Cancer: A Case Report
title_full_unstemmed Volvulus of the Sigmoid Colon Associated With Rectal Cancer: A Case Report
title_short Volvulus of the Sigmoid Colon Associated With Rectal Cancer: A Case Report
title_sort volvulus of the sigmoid colon associated with rectal cancer: a case report
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5051175/
https://www.ncbi.nlm.nih.gov/pubmed/27785289
http://dx.doi.org/10.14740/gr619w
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