Online First
Clinical Images  |   October 2020
Retained Colon in the Subcutaneous Fat After Colostomy Reversal
Author Notes
  • From the Adams Health Network in Decatur, Indiana. 
  •  *Address correspondence to Meaghan K. Arndts, DO, 1617 Woodedge Ave Springfield, Ohio 45504-1363. Email: arndtsmk@aol.com.
     
  • Financial disclosures: None reported. 
  • Support: None reported. 
Article Information
Clinical Images   |   October 2020
Retained Colon in the Subcutaneous Fat After Colostomy Reversal
The Journal of the American Osteopathic Association Published Online First on October 26, 2020. doi:https://doi.org/10.7556/jaoa.2020.153
The Journal of the American Osteopathic Association Published Online First on October 26, 2020. doi:https://doi.org/10.7556/jaoa.2020.153
A 58-year-old woman presented to a general surgery center in 2019 with a painful lump and intermittent drainage. She had undergone a Hartmann procedure in 2008 for diverticulitis, followed by sigmoid colectomy with reversal of colostomy 6 months later. In 2011, she developed a painful lump near her old colostomy site. She noted that the lump waxed and waned in size; it would periodically become red and drain fluid. In 2015, she underwent exploratory laparotomy with closure of an enterocutaneous fistula, but this did not resolve her symptoms. After she presented to our office with continued pain and intermittent drainage from the lump, a CT scan was performed, which demonstrated bowel in the subcutaneous fat, no hernia, and no connection to intra-abdominal bowel (image A). The patient underwent surgical excision, and intraoperative findings and pathology were consistent with retained colon containing inspissated stool (image B). The patient's symptoms resolved after this procedure. 

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