Journal of the Formosan Medical Association
Volume 106, Issue 2, Supplement , Pages S32-S36, 2007

Heterotopic Mesenteric Ossification After Total Colectomy for Bleeding Diverticulosis of the Colon—A Rare Case Report

  • Huang-Jen Lai

      Affiliations

    • Division of Colorectal Surgery, Department of Surgery, Tri-Service General Hospital, Taipei, Taiwan
    • ,
  • Shu-Wen Jao

      Affiliations

    • Division of Colorectal Surgery, Department of Surgery, Tri-Service General Hospital, Taipei, Taiwan
    • ,
  • Tsai-Yu Lee

      Affiliations

    • Division of Colorectal Surgery, Department of Surgery, Tri-Service General Hospital, Taipei, Taiwan
    • ,
  • Jing-Jim Ou

      Affiliations

    • Division of Colorectal Surgery, Department of Surgery, Tri-Service General Hospital, Taipei, Taiwan
    • ,
  • Jung-Cheng Kang

      Affiliations

    • Division of Colorectal Surgery, Department of Surgery, Tri-Service General Hospital, Taipei, Taiwan
    • Division of Colorectal Surgery, Department of Surgery, Buddhist Tzu Chi General Hospital, Hualien, Taiwan
    • Corresponding Author InformationCorrespondence to: Dr Jung-Cheng Kang, Division of Colorectal Surgery, Department of Surgery, Tri-Service General Hospital, 325, Section 2, Cheng Kong Road, Taipei 114, Taiwan

Received 18 October 2005; received in revised form 23 January 2006; accepted 4 April 2006.

Article Outline

Heterotopic bone formation within an abdominal incision is a rare sequela of abdominal surgery. Only a few previous reports have noted heterotopic ossification in the mesentery of the small intestine and periileostomy. Here, we report the case of a 60-year-old man who underwent emergent laparotomy and total colectomy with end ileostomy and developed this condition 1 month postoperatively. Heterotopic ossification in the peri-ileostomy tissue caused stenosis of the ileostoma. Laparotomy for re-anastomosis due to a large bone formation at an abdominal midline scar is very difficult and results in a massive abdominal wall defect. Therefore, we used a lower transverse incision to avoid the site of bone formation and resected the terminal ileum with its ossified mesentery. Then, we successfully carried out an anastomosis between the ileum and the rectum. The possible pathogenesis is a metaplastic mechanism of differentiation of immature multipotent mesechymal cells. Our case provides the experience of treatment and new perspective on currently held hypotheses of heterotopic bone formation. [J Formos Med Assoc 2007;106(2 Suppl):S32-S36]

Key Words:  ectopic bone formation , heterotopic ossification , intra-abdominal , mesenteric ossification , myositis ossificans

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PII: S0929-6646(09)60350-8

doi:10.1016/S0929-6646(09)60350-8

Journal of the Formosan Medical Association
Volume 106, Issue 2, Supplement , Pages S32-S36, 2007

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