Case Report
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jun 16, 2022; 10(17): 5805-5809
Published online Jun 16, 2022. doi: 10.12998/wjcc.v10.i17.5805
Heterotopic ossification beneath the upper abdominal incision after radical gastrectomy: Two case reports
Xiang Zhang, Ping-Tian Xia, Yan-Chao Ma, Yong Dai, Yan-Lei Wang
Xiang Zhang, Ping-Tian Xia, Department of Colorectal Surgery, Qilu Hospital of Shandong University, Jinan 250012, Shandong Province, China
Yan-Chao Ma, Department of Radiology, Qilu Hospital of Shandong University, Jinan 250012, Shandong Province, China
Yong Dai, Department of Colorectal and Anal Surgery, Qilu Hospital of Shandong University, Jinan 250012, Shandong Province, China
Yan-Lei Wang, Department of General Surgery, Qilu Hospital of Shandong University, Jinan 250012, Shandong Province, China
Author contributions: Zhang X, Dai Y and Wang YL were the patients’ surgeons, reviewed the literature and drafted the manuscript; Xia PT and Ma YC contributed to the manuscript drafting; Ma YC created figures and interpreted the imaging findings; all authors approved the final version of the manuscript.
Supported by the Clinical and Practical New Technology Development Fund of Qilu Hospital of Shandong University.
Informed consent statement: Informed written consent was obtained from the patients for the publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
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: Yan-Lei Wang, MD, PhD, Chief Doctor, Department of General Surgery, Qilu Hospital of Shandong University, No. 107 West Wenhua Road, Jinan 250012, Shandong Province, China. yanleiwang@hotmail.com
Received: November 24, 2021
Peer-review started: November 24, 2021
First decision: December 27, 2021
Revised: December 31, 2021
Accepted: April 3, 2022
Article in press: April 3, 2022
Published online: June 16, 2022
Processing time: 196 Days and 22.8 Hours
Abstract
BACKGROUND

Heterotopic ossification (HO) is a rare clinical phenomenon that refers to bone formation in nonossifying tissues.

CASE SUMMARY

This report presents two cases of HO beneath the upper abdominal median incision after radical gastrectomy. The first patient had postoperative pain below the incision area. There were no signs of anastomotic leakage, and the wound healed. Computed tomography (CT) findings 2 wk postoperatively were negative for HO, but the 6-wk CT showed HO beneath the incision. The patient refused reoperation, and after conservative therapy, the pain was gradually relieved after 2 wk. In the second case, postoperative recovery was uneventful, and HO was only detected on routine follow-up CT after 4 mo. An anti-adhesion membrane was applied beneath the peritoneum in both patients. Our findings suggest that HO beneath the abdominal incision might form at approximately 1 mo postoperatively. It may cause intractable pain; however, reoperation is usually not required.

CONCLUSION

In our cases, we suspect that HO may be related to the use of foreign materials beneath the peritoneum, which needs to be further investigated.

Keywords: Heterotopic ossification; Upper abdominal incision; Radical gastrectomy; Case report

Core Tip: Heterotopic ossification (HO) beneath the upper abdominal incision is a rare clinical phenomenon that refers to bone formation in nonossifying tissues. In our cases, we suspect that HO may be related to the use of foreign materials beneath the peritoneum, which needs to be further investigated.