A Rare Case Report of Iatrogenic Caecal Perforation

Abstract

ABSTRACT:A Caecum perforation is a very rare identity. Traumatic caecal perforations are even rare. Exteriorization of the caecum may be necessary when the duration of the perforation has been prolonged, here in the present case an attempt was made with primary repair with peritoneal lavage and patient recovered uneventfully. KEYWORDS: Primary repair, cecal perforation. CASE REPORT:A 72-year-old female patient was referred to department of surgery for generalized abdominal pain of 3 days duration. There was a history of constipation lasting for 3 days. There was no vomiting. Patient had undergone open reduction and internal fixation for right intertrochanteric fracture femur following self-fall six days ago in the orthopedic department. Patient was started on oral diet 6 hours following the surgery and had only complaints of pain at the surgical site. There were no known co-morbidities.On physical examination, she had tachycardia (pulse rate of 110/ min). Abdomen was distended. There was generalized abdominal tenderness and guarding. Liver dullness was obliterated. The bowel sounds were absent. The haemogram showed leucocytosis (11000/Cu mm). Chest X-ray showed free air under the diaphragm. A preoperative diagnosis of hollow viscus perforation with peritonitis was made and the patient was taken up for emergency laparotomy.On laparotomy, there was caecal perforation with faecal peritonitis. The perforation was 0.2 X 0.2 cm with healthy margins. There were no adhesions and rest of the bowel loops, appendix and liver and spleen were normal.