A mobile cecum predisposing to a major complication of laparoscopic assisted ileostomy.
Laparoscopic-assisted stoma creation is becoming a more popular procedure in the adult surgical population. Our institution has previously reported the use of the laparoscopic assisted colostomy (LAC) in children. In this paper, we describe an important complication in a 4-year-old patient, with trisomy 21, who underwent a laparoscopic-assisted loop ileostomy (LAI) and, subsequently, developed a volvulus of the cecum around the loop ileostomy. We suggest that when LAI is performed, cecal mobility should be carefully evaluated. In the absence of adequate cecal peritoneal attachments, an additional procedure to fix the cecum should be considered to prevent a potential volvulus around the stoma.
Carli
Claudio De
CD
Division of Pediatric Surgery, Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada.
Bass
Juan
J
Sweeney
Brian
B
D002429:Cecal Diseases / Q000517:prevention & control*; D002432:Cecum / Q000473:pathology*; D002675:Child, Preschool; D006801:Humans; D007081:Ileostomy / Q000009:adverse effects / Q000379:methods*; D045822:Intestinal Volvulus / Q000517:prevention & control*; D010535:Laparoscopy; D008297:Male; D011183:Postoperative Complications