Abstract
A 67-year-old woman visited our hospital for abdominal pain and distension. She was given a diagnosis of recurrent pseudo-obstruction associated with progressive systemic sclerosis (PSS) two years ago, and a transverse-colostomy was performed seven months after the first onset of intestinal obstruction because conservative treatment was not successful. She was hospitalized, and a conservative treatment with long tube drainage from the stoma was started. However her condition was not improved. Colonic volvulus and stenosis were found by abdominal computed tomography (CT) and colonoscopy, and subsequently surgery was performed. The wondering right colon was twisted 180 degrees clockwise around the stoma, but was not necrotized. We found the colon at the splenic flexure blind-ended proximal and distal segment with a mesenteric defect. Subtotal colectomy and ileostomy was performed. She was discharged in combination with parenteral nutrition and oral intake. This is a rare case of acquired intestinal atresia in an adult. Local ischemia and ongoing inflammation with further resorption of the devitalized segment and subsequent healing were likely involved.
