Nonsurgical treatment of postoperative intestinal obstruction caused by heterotopic ossification of the mesentery: A case report.

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.