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A D V E R T I S E M E N T
A D V E R T I S E M E N T
A 64-year-old man presented with acute onset of steady abdominal pain. He had undergone abdominoperineal resection (see abdominoperineal resection) for rectal cancer 15 years previously. Abdominal exam revealed distention and moderate diffuse tenderness with absent bowel sounds. Abdominal X-ray showed massively distended colon with a pattern consistent with cecal volvulus (see cecal volvulus and cecal bascule).
A D V E R T I S E M E N T
The patient was taken to the operating room for emergency laparotomy. The left lower quadrant end colostomy is shown. An adherent plastic barrier drape was placed over the abdomen and stoma after the abdomen was prepped.
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A D V E R T I S E M E N T
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The abdomen was opened through the prior midline incision. Omental adhesions to the abdominal wall were separated. A tongue of omentum adherent to the right side of the abdominal wall was compressing the ascending colon and was probably the cause of chronic cecal dilatation which ultimately led to volvulus. The omental band was divided.
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This page was last modified on 10/6/2003.
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