A CASE OF COMPLETE ANASTOMOTIC OBSTRUCTION AFTER SIGMOIDECTOMY TREATED BY ENDOSCOPIC INCISION AND DILATATION WITH A BILATERAL APPROACH

Abstract

A 53-year-old man underwent sigmoidectomy with diverting loop ileostomy for sigmoid-vesical fistula owing to diverticulitis of the sigmoid colon. After 5 months, ileostomy closure was scheduled; however, preoperative endoscopic examination revealed complete anastomotic obstruction. Although surgery was considered, minimally invasive endoscopic treatment was deliberated. Endoscopic incision and balloon dilatation using trans-ileostomic and anal endoscopes were successfully performed without intestinal perforation, and the patient underwent successful ileostomy closure. The combined antegrade-retrograde endoscopic rendezvous technique for complete occlusion of the anastomotic site appears to be a minimally invasive and effective treatment method.