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Case report
Early Postoperative Anastomotic Obstruction due to an Intraluminal Blood Clot after Laparoscopic Anterior Resection
Soon Keun Kwon2orcid , Yong Sik Yoon1orcid , Jin Soo Han3, Jihyun Seo4

DOI: https://doi.org/10.3393/ac.2020.06.11.2
Published online: October 29, 2020
1Division of Colon and Rectal Surgery, Department of Surgery, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
2Department of Colorectal Surgery, Seoul Yang Hospital, Seoul, Korea
3Division of Colorectal Surgery, Department of Surgery, Hanil General Hospital, Seoul, Korea
4Division of Colorectal Surgery, Department of Surgery, Korea University College of Medicine, Korea University Guro Hospital, Seoul, Korea
Corresponding author:  Yong Sik Yoon, Tel: 02-3010-3510, Fax: 02-3010-6701, 
Email: yoonys@amc.seoul.kr
Received: 27 February 2020   • Revised: 3 June 2020   • Accepted: 11 June 2020
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Abstract

Early postoperative anastomotic obstruction after colorectal surgery rarely develops. Herein, we present a case of a 50-year-old healthy woman who had an early postoperative anastomotic obstruction which was revealed caused by a blood clot and successfully managed by endoscopic approach. The patient discharged after laparoscopic anterior resection and visited the emergency department one day after because of abdominal pain. Computed tomography showed that the anastomosis site was obstructed with low-density material. Intraoperative endoscopy was performed under general anesthesia and blood clot filling the lumen were identified. As the scope was advanced to the blood clot with air inflation, the blood clot was evacuated. The anastomosis site could be obstructed by blot clot with mucous debris albeit it is a rare condition. An endoscopic approach seems to be the first option in the diagnosis and treatment of postoperative obstruction at the anastomosis site and it could prevent unnecessary laparotomy.

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