A Case of Ileus Due to Incarceration of the Small Intestine Into a Reconstructed Pelvic Floor After Abdominoperineal Resection of the Rectum

Abstract

We report herein on a case of ileus due to incarceration of the small intestine into a reconstructed pelvic floor after abdominoperineal resection of the rectum. A 58-year-old male underwent abdominoperineal resection for advanced rectal cancer. On day 6 post-surgery, the patient complained of epigastralgia and nausea; X-ray films revealed post-operative ileus. He was managed with long intestinal tube decompression, but the ileus did not improve. Plain pelvic computed tomography showed a space occupied lesion (SOL) 4cm in diameter under the reconstructed pelvic floor. During surgery done at this time, it was found that a portion of the small intestine located 10cm proximal to the terminal ileum was incarcerated into the reconstructed pelvic floor. The small intestine was decompressed, and the pelvic floor was reconstructed. The incarcerated small intestine could be preserved as it was not necrotic. The patient's post-clinical course was uneventful and chemotherapy was started.