A Case of Loop Ileostomy Prolapse Successfully Treated with Stapled Modified Altemeier Method

Abstract

We report a case of loop ileostomy prolapse in an 89-year-old woman with a history of unresectable sigmoid colon cancer. The patient was admitted to our hospital with severe abdominal pain during the follow-up period. An initial examination revealed intestinal prolapse of the afferent limb of a loop ileostomy, resulting in strangulation and obstruction, which was not relieved by manual reduction. We used the stapled Altemeier operation for loop stoma prolapse. This technique involves a simple operation, which includes a circumferential incision through the full thickness of the outer and inner cylinder of the prolapsed limb, followed by stapled prolapse resection without incising the abdominal wall. The postoperative course was uneventful and the patient showed no early recurrence of prolapse. This procedure is useful as an optional surgical treatment for cases of loop ileostomy prolapse because of its decreased invasiveness compared to open exploration. We present a case of loop ileostomy prolapse successfully treated with the stapled Altemeier operation, and provide a review of the current literature on this topic.