A rare cause of Hartman resection?

Abstract text (incl. references and figure legends)

Case history

A 88 year old patient presented with 4 weeks history of vomiting and abdominal pain , with associated abdominal distension

clinical findings

On examination patient was haemodynamically stable , with distended and hyperresonant percussion and tender in left iliac fossa

Investigation/Results

Patient abdominal xray showed circular opacity in sigmoid colon with a size of 34.9 mm

Ct Abdomen and pelvis with contrast showed peripherally calcified laminated material and sigmoid diverticular disease.

A flexible sigmoidoscopy also showed impacted stone in sigmoid colon region.

Diagnosis

The working diagnosis was stone stuck in recto sigmoid region which is rare entity

Therapy and Progressions

Our patient underwent hartman resection and made uneventful recovery following that .

Comments

Intervention in the correct time and deciding best surgical approach before the patient deteriorates or becomes clinically unstable is essential

References

1)Sigmoid gallstone ileus: a challenging diagnosis Renuka Maleniea , Lisa Leoneb , MGF Gillilandb How to cite: Malenie R, Leone L, Gilliland MGF. Sigmoid gallstone ileus: a challenging diagnosis. Autopsy Case Rep [Internet]. 2019 9(2):e2019102. https://doi.org/10.4322/acr.2019.102

2)A systematic review of gallstone sigmoid ileus management Nicholas Farkas∗ , Vasha Kaur, Arun Shanmuganandan, John Black, Chantal Redon, Adam E. Frampton, Nicholas West Epsom and St Helier University Hospitals, Wrythe Lane, Carshalton, Sutton, London, SM5 1AA, United Kingdom

3)Images In... Sigmoid gallstone ileus: a rare cause of large bowel obstruction NT Ventham,1 T Eves,1 D Raje,2 P Willson2 1 London Deanery, London, UK 2 Department of General Surgery, Kingston Hospital, London, UK Correspondence to NT Ventham, n.ventham@hotmail.co.uk

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