A Case Report of Mechanical Intestinal Obstruction Caused by Delayed Heterotopic Ossification of Postoperative Incision.

Heterotopic ossification (HO) refers to the abnormal formation of mature lamellar bone within soft tissues where bone is not typically present, such as muscles, tendons, ligaments, and joint capsules. While commonly associated with trauma, spinal cord injury, or orthopedic procedures, abdominal incisional heterotopic ossification (AIHO) is exceedingly rare. Its pathogenesis may be closely related to local trauma, inflammatory responses, and genetic predisposition. AIHO typically occurs between 3 months and 5 years postoperatively, with an estimated incidence of 0.3%-1.2% among all HO cases. Ossified masses can compress or mechanically tether the intestines, resulting in bowel obstruction. Herein, we report a rare case of AIHO causing mechanical intestinal obstruction 20 years after a hysterectomy. The diagnosis was confirmed by abdominal computed tomography, and the patient underwent successful surgical resection. We also review the literature and summarize strategies for the management and prevention of this complication.