Chen JT, Li YP, Guo SQ, Huang JS, Wang YG. Nonsurgical treatment of postoperative intestinal obstruction caused by heterotopic ossification of the mesentery: A case report. World J Gastrointest Surg 2025; 17(3): 99015 [DOI: 10.4240/wjgs.v17.i3.99015]
Corresponding Author of This Article
Yong-Gang Wang, Department of Colorectal and Anal Surgery, Shanxi Provincial People’s Hospital, Shanxi Medical University, No. 29 Shuangta East Street, Taiyuan 030012, Shanxi Province, China. wygcp@163.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Surg. Mar 27, 2025; 17(3): 99015 Published online Mar 27, 2025. doi: 10.4240/wjgs.v17.i3.99015
Nonsurgical treatment of postoperative intestinal obstruction caused by heterotopic ossification of the mesentery: A case report
Jing-Tian Chen, Yao-Ping Li, Shang-Qi Guo, Jin-Sheng Huang, Yong-Gang Wang
Jing-Tian Chen, Yao-Ping Li, Shang-Qi Guo, Jin-Sheng Huang, Yong-Gang Wang, Department of Colorectal and Anal Surgery, Shanxi Provincial People’s Hospital, Shanxi Medical University, Taiyuan 030012, Shanxi Province, China
Author contributions: Chen JT collected data and wrote the manuscript; Guo SQ and Huang JS contributed to the literature search; Wang YG and Li YP designed the study; and all the authors have read and approved the final manuscript.
Supported by Major Basic Research Project of Shanxi Provincial Natural Science Foundation, No. 202203021221185 and No. 202103021224379.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Yong-Gang Wang, Department of Colorectal and Anal Surgery, Shanxi Provincial People’s Hospital, Shanxi Medical University, No. 29 Shuangta East Street, Taiyuan 030012, Shanxi Province, China. wygcp@163.com
Received: July 11, 2024 Revised: December 14, 2024 Accepted: January 7, 2025 Published online: March 27, 2025 Processing time: 227 Days and 19.5 Hours
Abstract
BACKGROUND
Among all forms of heterotopic ossification, heterotopic mesenteric ossification (HMO) is rare, with fewer than 100 reported cases to date. Postoperative early small bowel obstruction caused by HMO is even rarer, presenting extremely high surgical risks, the potential for multiple surgeries, and a poor prognosis. There have been no reported cases of conservative treatment for resolving such early postoperative obstruction.
CASE SUMMARY
A 57-year-old male presented with severe postoperative small bowel obstruction shortly after undergoing open radical resection for transverse colon cancer. Laparotomy revealed extensive adhesions in the proximal jejunum and mesentery, making it too difficult to relieve without injuring the small bowel. Additionally, multiple fixed nodules were found in the mesentery during the operation. Pathology confirmed the presence of heterotopic ossification. The patient was treated with methylprednisolone on postoperative day 1, which gradually relieved his symptoms.
CONCLUSION
Hormone therapy may have a potential role in treating small bowel obstruction caused by early HMO after operative intervention.
Core Tip: In this case, we present a unique treatment approach for resolving early postoperative heterotopic ossification of mesentery-induced small bowel obstruction. There was difficulty dissecting the small bowel obstruction during the second surgery, thus we tried treatment with methylprednisolone, which gradually relieved the patient’s bowel obstruction, thereby providing a new and effective strategy for early postoperative heterotopic ossification of the mesentery-induced small bowel obstruction and hypothesizing that early postoperative heterotopic ossification of the mesentery is a specific postoperative inflammatory response.
