case_images: PMC11045211_01
case_images: Contrast-enhanced computed tomography findings. In the horizontal (a) and coronal (b) sections, thickening of the wall of the descending colon and an increase in fat concentration around the wall are observed, and a small amount of air is observed in the mesentery near the intestinal wall (arrow). In the coronal section (b), a descending colon stricture was observed (arrowhead) where endoscopic balloon dilation was performed.
case_images: crg-2024-0018-0001-537973_F01.jpg
case_images: PMC11045211_01_crg-2024-0018-0001-537973_F01.jpg
case_images: F1
case_images: C-reactive protein concentration of 0.92 mg/dL, indicating a slight inflammatory reaction; there were no other notable abnormal findings. Computed tomography revealed thickening of the descending colon wall, increased fat concentration around the wall, and some air in the mesentery near the intestinal wall (Fig. 1).
case_images: Fluoroscopic image during endoscopic balloon dilatation and colonoscopy images before and after surgery. a Fluoroscopic imaging showed stricture in the descending colon (arrow). b Endoscopic balloon dilation was performed for descending colon stricture. c Preoperative colonoscopy images showed a stenosis in the center of the image (arrow). The mucosa in the endoscopic balloon dilation area was clear. d Postoperative colonoscopy revealed a scar (arrow) and an inflammatory polyp (arrowhead) 30 cm from the anal verge that was not seen on preoperative colonoscopy.
case_images: crg-2024-0018-0001-537973_F02.jpg
case_images: PMC11045211_01_crg-2024-0018-0001-537973_F02.jpg
case_images: F2
case_images: Notably, the descending colon had undergone endoscopic balloon dilatation multiple times (Fig. 2a, b), which was thought to be a contributing factor. Postoperative colonoscopy revealed a scar and an inflammatory polyp on the anal side of the endoscopic balloon dilation site, 30 cm from the anal verge, which was not seen during preoperative colonoscopy (Fig. 2c, d), and fluoroscopic examination showed no leakage of the contrast medium.
case_images: Intraoperative imaging findings. a An edematous mesenteric area with white moss and redness was observed in the descending colon. b A moderate amount of cloudy ascites was observed in the pelvis (arrow).
case_images: crg-2024-0018-0001-537973_F03.jpg
case_images: PMC11045211_01_crg-2024-0018-0001-537973_F03.jpg
case_images: F3
case_images: The perforated area was identified using forceps, and an edematous mesenteric area with white moss and redness was found in the descending colon (Fig. 3).