Rare complication after anterior resection of the rectum and colon reconstruction: severe constipation with obstructed defecation. Report of a case.

OBJECTIVE The aim of this manuscript is to verify the impact that some recanalization procedures for intestinal continuity could have in bowel function and quality of life. STUDY MATERIAL We describe a clinical case of a rectal cancer patient who underwent anterior resection of the rectum with colo-anal anastomosis, colo-plasty and diverting ileostomy. RESULTS After the diverting ileostomy closure, suffered of severe bowel function problems. The establishment of a colo-plasty caused a syndrome of such severe obstructed defecation to necessitate the reestablishment of a diverting ileostomy. DISCUSSION Anterior resection with total mesorectal excision and colo-anal anastomosis is the gold standard surgical treatment of rectal carcinoma. The so called "anterior resection syndrome" is well known after such surgical procedures. The establishment of a reservoir such as the J-pouch and more recently the transverse pouch (colo-plasty) are procedures used to improve the quality of life after anterior resection of the rectum. CONCLUSIONS The presence of bowel obstruction without mechanical causes makes us consider the colo-plasty as its cause with a Hirschprung like mechanism or similar to the "obstructed defecation". The peristalsis stops at the colo-plasty level impeding the progression of feces. The colo-plasty or the pouch do not function as a reservoir to accommodate feces, but because they stop the peristalsis.