VM88 - Surgical Resolution in Uncommon Pathology: Laparoscopic Sigmoidectomy for Obstructed Localized Colonic Amyloidosis

Purpose/Background: Amyloidosis is an uncommon medical condition characterized by the presence of abnormal extracellular protein deposits, leading to tissue distortion and functional impairment. Our case involves a 56-year-old female patient without any known underlying health issues, who was coincidentally diagnosed with amyloidosis in her colon during a routine colonoscopy in 2018. Subsequently, the patient experienced symptoms such as constipation, bloating, and a decrease in the caliber of her stool. Four years after the initial diagnosis, the patient was admitted to our medical facility due to obstructive symptoms. Diagnostic assessments, including an abdominal CT scan, revealed a progressive increase in the thickening of the colon wall in the sigmoid region. A colonoscopy was performed, during which only a pediatric-sized scope could pass through a polypoid mass in the mid-sigmoid colon. A new 2cm-sized polypoid mass was also observed in the rectum, approximately 10cm from the anal verge. To facilitate future medical procedures, the sigmoid mass was marked with tattoos both proximally and distally, as was the area distal to the rectal mass. However, the patient declined the removal of the rectal mass, as it might necessitate a temporary ileostomy, choosing instead to monitor her condition.

Methods/Interventions: A laparoscopic sigmoidectomy was performed, and the presence of tattoo markings proximal and distal to the sigmoid mass was observed during the surgery. The sigmoid colon was resected while preserving the superior rectal artery, and an end-to-end stapled anastomosis was created.

Results/Outcomes: A laparoscopic sigmoidectomy was performed, and the presence of tattoo markings proximal and distal to the sigmoid mass was observed during the surgery. The sigmoid colon was resected while preserving the superior rectal artery, and an end-to-end stapled anastomosis was created.

Conclusion/Discussion: In this video presentation, we showcase a successful laparoscopic sigmoidectomy as a surgical approach for resolving symptoms of obstruction in a rare case of localized colonic amyloidosis located in the sigmoid colon.