A Case of Colectomy and Adnexectomy for Gangrenous Ischemic Colitis Caused by a Large Ovarian Tumor

Abstract

A large ovarian tumor was discovered incidentally in a 76-year-old woman during medical treatment for acute myocardial infarction. Seven months later, the patient developed abdominal pain and was transported to our hospital by ambulance. Abdominal computed tomography revealed a large ovarian tumor compressing the sigmoid colon, causing necrosis and perforation of the colon. Emergency surgery confirmed compression of the necrotic sigmoid colon and mesenterium by the large ovarian tumor. Sigmoidectomy and left adnexectomy with partial ureterectomy were performed. Because bleeding from the surgical site could not be controlled, we chose to perform abdominopelvic packing and open abdomen management. After the patient was stabilized with surgical critical care, we performed a colostomy and ureteroureterostomy on the day after the surgery. Damage control surgery with abdominopelvic packing and open abdomen management proved to be an effective strategy for hemorrhage control in the patient with acute panperitonitis.