Case Report A CURIOUS CASE OF PASSING GANGRENOUS COLON PER RECTUM: A CURIOUS CASE OF PASSING GANGRENOUS COLON PER RECTUM

Dr. Sanjay Chatterjee; Keshavi Mehta

doi:10.15713/ins.bhj.157

Authors

Dr. Sanjay Chatterjee a:1:{s:5:"en_US";s:64:"Assistant professor, General surgery department, Bombay Hospital";}
Keshav Mehta Assistant Professor, Maharashtra University of health sciences, Nashik Postgraduate Teacher, Bombay hospital Institute of Medical Sciences

DOI:

https://doi.org/10.15713/ins.bhj.157

Abstract

We report a case of a 66 year old male who presented with bleeding per rectum since 3-4 months. He had a history of being operated for hemorrhoidectomy 9 years ago. He underwent a colonoscopy which detected a large sessile polyp at the rectosigmoid junction for which polypectomy was done. The histopathology of the polyp revealed moderately differentiated adenocarcinoma arising within the villoglandular polyp (malignant polyp) with base involved. He was then operated for anterior resection followed by colorectal anastomosis. There was an anastomotic leak noted in the post operative period for which the patient was re-explored and Hartmans procedure was done in view of gangrenous sloughing of descending colon with resultant leak. 7 months later, patient was taken up for soma reversal and a covering ileostomy was done. He later followed up with an entire bowel wall coming out per rectum.It is a rare and poorly understood case of colonic mucosal sloughing out per rectum presenting without high fever, tachycardia, a rigid abdomen and hemodynamic instability.