Clearing the obstructed small bowel via an orifice in the caecum after a resected appendix: a case report and presentation of the technique

Andrzej Żyluk, Zbigniew Szlosser, Maciej Iwanicki


A patient suffering from a mechanical obstruction of the distal sigmoid colon for several days, caused by a tumour invading the bowel circuitously, is reported. Intraoperatively, an extensive distension of the whole colon and the small intestine was noted. The operation consisted of a sigmoidectomy (with the tumour) followed by an end-colostomy on the descending colon (Hartmann operation). The colon was then cleared by “milking” the faecal contents to the end of the sigmoid colon. The distended small bowel was successfully cleared via an orifice in the caecum after a resected appendix. Although the presented technique seems to be simple, the authors did not find a similar method of clearing the small bowel in the literature.


large bowel obstruction; small bowel clearing; vermiform appendix

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