A Case Experiencing Two Idiopathic Colon Perforations

Ikenishi, Kazumi; Narikiyo, Michihiro; Shino, Yoshihide; Nakatani, Katsunori

doi:10.3919/jjsa.71.742

Cited by 4 publications

(1 citation statement)

References 8 publications

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“…We searched for case reports published from April 1995 to December 2019 in the Japan Medical Abstracts Society and PubMed database using the keywords "spontaneous perforation" or "stoma limb perforation." The search resulted in nine cases, including ours (Table 2) [3][4][5][6][7][8][9][10][11][12][13]. Colectomy and revision of stoma (including stoma closure) were chosen as the treatment methods in eight cases.…”

Section: Discussionmentioning

confidence: 99%

Successful multi-stage treatment of stoma limb perforation following Hartmann’s operation report a case

Kataoka¹,

Nitta²,

Ota³

et al. 2020

surg case rep

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Background: Stoma-related complications are not rare, whereas the spontaneous perforation of the stoma limb is relatively rare. Herein, we report a case of stoma limb perforation which occurred after Hartmann's operation. Case presentation: A 50-year-old Japanese man presented to our Hospital with acute and severe abdominal pain. Abdominal computed tomography (CT) scan revealed that an abscess with free air was formed around the sigmoid colon. We performed Hartmann's operation, whereas he experienced redness, purulent discharge, and swelling around the colostomy at 10 days postoperatively. The contrast-enhanced CT scan of the abdomen revealed an abscess formation with air around the colostomy. He was diagnosed with an abdominal wall abscess due to perforation of the stoma limb. After the drainage, his symptoms were ameliorated by oral analgesics, anti-inflammatory drugs, and prophylactic antibiotic. Four months after the first operation, we performed a closedown of the sigmoid colostomy and fistula resection. The patient's postoperative course was uneventful, and he was discharged 14 days later. Conclusions: This case depicts rare complications of Hartmann's operation. Operation is usually performed in patients with stoma limb perforation. However, if they are stable and the abscess is located in their abdominal wall, they may be treated successfully using a multi-stage approach of local drainage toward the stoma wall followed by stoma closure.

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