Stercoral perforation of the normal colon: report of five cases

Velitchkov, Nadko G.; Losanoff, Julian E.; Kjossev, Kirien T.; Григоров, Г; Vezdarova, Meglena; Kirov, G

doi:10.1590/s1516-31801996000600007

Cited by 5 publications

(14 citation statements)

References 4 publications

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“…Surgical pathologic examination is necessary to make a definite diagnosis. According to Berry’s classification,2 31 (59.62%) patients were diagnosed with stercoral perforations and the other 21 (40.38%) were diagnosed with idiopathic perforations by surgical pathologic examination.…”

Section: Discussionmentioning

confidence: 99%

“…and "idiopathic" perforations on the basis of the etiopathologic causes of the lesions. 2 As China's aging population grows, more attention should be given to SCP because these types of clinical cases have been increasing gradually. This disease is more common in elderly individuals.…”

mentioning

confidence: 99%

“…In 1984, J.A. Berry classified spontaneous perforations into “stercoral” and “idiopathic” perforations on the basis of the etiopathologic causes of the lesions 2. As China’s aging population grows, more attention should be given to SCP because these types of clinical cases have been increasing gradually.…”

mentioning

confidence: 99%

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Laparoscopic Management of Spontaneous Colonic Perforation: A Single Institution Study of 52 Patients

Zheng

et al. 2022

Surgical Laparoscopy, Endoscopy &Amp; Percutaneous Techniques

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Background: Spontaneous colonic perforation (SCP) is associated with an devastating result. The use of laparoscopy for SCP remains controversial. This study aimed to compare the postoperative outcomes of patients who received either laparoscopic or open surgery and to evaluate the efficacy of laparoscopic surgery and the risk factors affecting prognosis. Patients and Methods: A retrospective study of patients who underwent surgery for SCP from January 2005 to December 2020 was performed. Demographic data, intraoperative variables, length of stay, and surgical complications were retrieved. Results: A total of 52 patients were postoperatively diagnosed with SCP. Thirty (57.69%) procedures were performed using laparoscopic surgery (group A) and 22 (42.31%) were performed using open surgery (group B). There were no significant differences between groups A and B in terms of age, sex, chronic concomitant disease, chronic constipation, incentives, imaging findings, preoperative diagnosis, American Society of Anesthesiologists (ASA) score, Mannheim Peritonitis Index (MPI), operation time, days to resumption of liquids, site of perforation, surgical procedures, or types of perforation (P>0.05). The incidence of wound infection in group A was significantly lower than that in group B (P<0.05), but there was no significant difference in the incidence of abdominal abscess between the 2 groups (P>0.05). Significant differences were found in days to start walking and days to resumption of solids between the 2 groups (P<0.05). Group B had a longer length of hospital stay than group A (P<0.05). After multivariate analysis, the independent variables associated with worse perioperative complications were an age of 65 years and older, an ASA score of ≥3, and an MPI of >26. Conclusions: The prognosis of SCP is poor. The operation should follow principles that are simple, rapid, and effective. If there are no contraindications, laparoscopy may be the preferred method. Hartmann procedure is a promising surgical strategy. The age, ASA score, and MPI may indicate the severity and prognosis of SCP.

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

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Laparoscopic Management of Spontaneous Colonic Perforation: A Single Institution Study of 52 Patients

Zheng

et al. 2022

Surgical Laparoscopy, Endoscopy &Amp; Percutaneous Techniques

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“…Typical risk factors are chronic constipation, age >60, female sex, NSAIDs [ 3 , 4 , 5 , 6 ], heroin addiction [ 7 ], antacids, steroids, amitriptyline, and other constipating agents [ 8 , 9 , 10 ]. It has also been reported in patients receiving dialysis [ 8 ], patients on immunosuppressive therapy after kidney transplant [ 11 ], and those with spinal cord injury [ 10 ]. Perforation commonly occurs in the sigmoid colon (50%) and rectosigmoid junction (24%) [ 3 ].…”

Section: Discussionmentioning

confidence: 99%

Stercoral Ulcer-Associated Perforation and Chemotherapy

Mouchli

Meehan

2017

Case Rep Oncol

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“…Two hypotheses have been proposed to explain idiopathic perforations: Vascular theory which suggests combination of hypoperfusion of colonic tissue & constitutional weakness of the bowel wall with increased intraluminal pressure which results from intestinal hernia, rectal prolapse, or abnormal depth of Douglas pouch [16]. Stercoral perforation is common in sigmoid, rectosigmoid regions and less commonly found in the cecum [17] [18]. Idiopathic perforation occurs due to asymmetrical distribution of intraluminal pressure at the pelvi-rectal angle in absence of obvious impacted stool or any identifiable cause of perforation [19].…”

Section: Discussionmentioning

confidence: 99%

Spontaneous Perforation of Colon: A Case Report and Review of Literature

Makki¹,

Hejazi²,

Zaidi³

et al. 2014

CRCM

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Objective: To present a case of spontaneous perforation of colon. Introduction: Spontaneous perforation of colon (SPC) is defined as sudden perforation of apparently healthy colon in absence of diseases or injury. SPC is an uncommon clinical entity which is seldom reported in literature, less than 100 cases were reported. Case report: A 82-year-old gentleman presented to emergency room (ER) with acute abdominal pain, for few hours duration. Pain started paraumbilically with sudden onset and then with increasing intensity became generalized. It was associated with nausea and vomiting. On general examination, he was conscious, alert. His vital signs: afebrile, pulse: 106/m, B.P: 140/100, local examination showed generalized abdominal tenderness & guarding with absent intestinal sounds. P.R. exam showed remnants of stool with blood stain on gloves, no masses. Computerized tomography (CT) abdomen showed perforation of cecum. He was taken to operation room (OR) and right hemicolectomy was done. Post operative period was uneventful and he was discharged in good health. Conclusion: SPC is a serious condition with high morbidity and mortality due to delay in diagnosis and management so, every effort should be made to make diagnosis especially in elderly and prompt surgical intervention should be done.

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Stercoral perforation of the normal colon: report of five cases

Cited by 5 publications

References 4 publications

Laparoscopic Management of Spontaneous Colonic Perforation: A Single Institution Study of 52 Patients

Laparoscopic Management of Spontaneous Colonic Perforation: A Single Institution Study of 52 Patients

Stercoral Ulcer-Associated Perforation and Chemotherapy

Spontaneous Perforation of Colon: A Case Report and Review of Literature

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