Abstract
A 73-year-old male with an unresectable rectal carcinoma underwent sigmoid loop colostomy in 2010, responded to postoperative chemotherapy, and was alive and free of recurrence without treatment for 3 years. He developed a depressive state 1 week prior to presenting, and repeatedly attempted suicide. He was founsd lying in blood, and transported to hospital by ambulance. There were many shallow cut wounds in the abdomen, and the stoma was slightly damaged. However, many fragments of the small intestine were observed in the stoma pouch, suggesting that he had detached the stoma, reached into the abdominal cavity, relocated the small intestine outside the body, and cut it. An emergency laparotomy was performed, and a stoma stab wound was confirmed. In addition, a 40-cm jejunal portion 40 cm from the ligament of Treitz had been cut, showing bleeding. Full-thickness damage of the loop stoma was observed. The damaged portion was resected, and descending colon end colostomy was performed. This is an extremely rare case. In self-mutilation cases, the possible occurrence of states that cannot be visually confirmed should be taken into consideration, and immediate action is necessary.
