A Case of Stoma Limb Perforation Nine Years After Abdominoperineal Resection

Stoma limb perforation is an extremely rare complication of colostomy. We report a case of sigmoid colostomy limb perforation due to diverticulitis occurring nine years after abdominoperineal resection for rectal cancer. An 83-year-old man presented with redness and pain around his stoma. He had undergone abdominoperineal resection nine years earlier, resulting in a permanent sigmoid colostomy. Initial CT suggested cellulitis, and antibiotics were administered, but his condition worsened. A repeat CT revealed an abscess, leading to incision and drainage, which confirmed stoma limb perforation. Segmental resection of the perforated bowel and same-site stoma reconstruction were performed. Histopathological examination indicated diverticulitis as the cause. The postoperative course was uneventful, and he was discharged on the 27th day. This case highlights the risk of late-onset stoma limb perforation due to diverticulitis. Contrast-enhanced imaging was essential for diagnosis, and long-term stoma care, including constipation prevention and regular imaging, is crucial for preventing similar complications.