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Updated: May 12, 2026

Caudal-to-cranial Approach in Laparoscopic Right Hemicolectomy with Complete Mesocolon Excision and D3 Lymph Node Dissection

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Rectal volvulus following laparoscopic left hemicolectomy.

Paul Anthony Sutton¹, Han Sian Lee, Islah Din

¹Department of Molecular and Clinical Cancer Medicine, University of Liverpool, Liverpool, UK. paulsutton01@doctors.org.uk

BMJ Case Reports

|April 24, 2013

Summary

A 60-year-old patient experienced severe constipation due to rectal volvulus, a rare complication after colorectal surgery. Endoscopic decompression and a flatus tube successfully resolved the obstruction, preventing recurrence.

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Laparoscopic Left Hemihepatectomy Combined with Caudate Lobe Resection

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Area of Science:

Gastroenterology
Surgical Oncology

Background:

Colorectal cancer (CRC) management often involves surgical resection.
Post-hemicolectomy complications can include bowel obstruction.
Rectal volvulus is an uncommon cause of large bowel obstruction.

Observation:

A 60-year-old female, 2 years post-laparoscopic left hemicolectomy for Dukes B2 CRC, presented with acute absolute constipation.
Abdominal radiography and CT revealed large bowel obstruction localized to the rectum.
Initial suspicion of anastomotic recurrence was revised to rectal volvulus upon further imaging and endoscopic evaluation.

Findings:

Endoscopic decompression provided initial relief of the rectal volvulus.
Insertion of a flatus tube achieved effective decompression and symptom resolution.
The patient was discharged asymptomatic and remained symptom-free at 2-month follow-up.

Implications:

This case highlights rectal volvulus as a potential, albeit rare, cause of obstruction post-hemicolectomy.
Prompt diagnosis through imaging and endoscopy is crucial for appropriate management.
Minimally invasive endoscopic interventions can effectively treat rectal volvulus, avoiding more extensive surgery.