Abstract：
A 77-year-old man with complaining of anemia and abdominal pain was admitted to our hospital. An abdominal computed tomography showed the sigmoid colon tumor with bowel obstruction. Laparoscopic transverse colostomy was performed to release intestinal obstruction. After first operation, he was diagnosed the sigmoid colon cancer: cT4b(bladder), cN0, cM0, and cStage Ⅱc. Radical laparoscopic operation(Hartmann\'s operation)was performed. On the 4th postoperative day, fecal juice was discharged from the abdominal drain placed in the Douglas fossa, so emergency laparotomy was performed. The intraoperative findings showed perforation in the blind end of the descending colon. The descending colon was resected from a site approximately 5 cm anal side of the transverse colostomy to the blind end. It was thought that perforation occurred due to an increase in internal pressure in the residual intestinal tract after Hartmann\'s surgery without blood flow disorder. We believe that further attention is required to the management of residual intestinal tract at the blind end for the obstructive colorectal cancer.
摘要：
一名77岁的男子因贫血和腹痛而入院。腹部计算机断层扫描显示乙状结肠肿瘤伴肠梗阻。进行腹腔镜横结肠造口术以缓解肠梗阻。第一次手术后,他被诊断为乙状结肠癌：cT4b（膀胱），cN0、cM0和cStageⅡc。行根治性腹腔镜手术（Hartmann手术）。术后第4天,粪便汁从位于道格拉斯窝的腹部排水管排出，所以进行了紧急剖腹手术.术中发现降结肠盲端穿孔。降结肠从横向结肠造口术的肛门侧大约5cm的部位切除至盲端。据认为，穿孔的发生是由于哈特曼手术后残留肠道内压增加而没有血流障碍。我们认为，需要进一步关注阻塞性结直肠癌盲端残留肠道的管理。
