Rare complication after anterior resection of the rectum and colon reconstruction: severe constipation with obstructed defecation. Report of a case.
OBJECTIVE
The aim of this manuscript is to verify the impact that some recanalization procedures for intestinal continuity could have in bowel function and quality of life.


METHODS
We describe a clinical case of a rectal cancer patient who underwent anterior resection of the rectum with colo-anal anastomosis, colo-plasty and diverting ileostomy.


RESULTS
After the diverting ileostomy closure, suffered of severe bowel function problems. The establishment of a colo-plasty caused a syndrome of such severe obstructed defecation to necessitate the reestablishment of a diverting ileostomy.


CONCLUSIONS
Anterior resection with total mesorectal excision and colo-anal anastomosis is the gold standard surgical treatment of rectal carcinoma. The so called "anterior resection syndrome" is well known after such surgical procedures. The establishment of a reservoir such as the J-pouch and more recently the transverse pouch (colo-plasty) are procedures used to improve the quality of life after anterior resection of the rectum.


CONCLUSIONS
The presence of bowel obstruction without mechanical causes makes us consider the colo-plasty as its cause with a Hirschprung like mechanism or similar to the "obstructed defecation". The peristalsis stops at the colo-plasty level impeding the progression of feces. The colo-plasty or the pouch do not function as a reservoir to accommodate feces, but because they stop the peristalsis.
Franco
Salvatore
S
Department of Surgical Oncology, "Garibaldi" Hospital, Catania, Italy. fransalv@simail.it
Foresta
Gaspare
G
Lombardo
Vittorio
V
Giannone
Giorgio
G
D000368:Aged; D000714:Anastomosis, Surgical; D003082:Colectomy / Q000009:adverse effects* / Q000379:methods; D003248:Constipation / Q000209:etiology*; D003672:Defecation; D006801:Humans; D007081:Ileostomy; D007415:Intestinal Obstruction / Q000209:etiology / Q000601:surgery*; D008297:Male; D011183:Postoperative Complications / Q000209:etiology / Q000601:surgery*; D016737:Proctocolectomy, Restorative / Q000379:methods; D011788:Quality of Life; D012004:Rectal Neoplasms / Q000601:surgery; D012007:Rectum / Q000601:surgery*; D016896:Treatment Outcome