부산대학교 도서관

We report a rare case of gastric obstruction that followed sigmoid colostomy and required reoperation. An 81-year-old woman with kyphosis who had undergone abdominoperineal resection of the rectum and endsigmoid colostomy by the intraperitoneal approach for rectal cancer 5 months earlier was admitted for abdominal pain and projectile vomiting. Abdominal CT showed such marked dilatation of the stomach that it filled the abdominal cavity. There was no evidence of cancer recurrence or bowel obstruction. An upper gastrointestinal series revealed gastroptosis and that the gastric antrum was compressed by the sigmoid colostomy. Gastric obstruction secondary to sigmoid colostomy was diagnosed, and re-colostomy by the extraperitoneal pproach was performed. The postoperative course was uneventful, and the gastric obstruction was eliminated. To our knowledge, this is the first report of late gastric obstruction due to sigmoid colostomy. Colostomy by the extraperitoneal approach should be considered in patients with gastroptosis or kyphosis.