An Unusual Perforation of the Colon: Report of Two Cases

Matsuo, Shigetoshi; Eguchi, Susumu; Azuma, Takashi; Kanetaka, Kengo; Itoh, Shinichiro; Yamaguchi, Satoshi; Obata, Shiro; Kanematsu, Takashi

doi:10.1007/s005950200163

Cited by 17 publications

(4 citation statements)

References 9 publications

(12 reference statements)

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“…A literature search was conducted on the research database (MEDLINE) for all articles published in English from 1998 to 2017. MEDLINE retrieved 39 case reports, 7 , 10 – 47 including 46 patients, and four case series including 175 patients. 1 , 2 , 5 , 48 To this end, a total of 228 patients with SCPA were identified ( Figure 1 ).…”

Section: Methodsmentioning

confidence: 99%

Spontaneous colonic perforation in adults: Evaluation of a pooled case series

et al. 2020

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Spontaneous colonic perforation in adults (SCPA) is rare but important. Its clinicopathological features and outcomes remain unclear. Therefore, the aim of the current study was to explore and investigate the clinicopathological characteristics, clinical outcomes and potential risk factors for patients with SCPA. Data of seven patients with SCPA treated in our hospitals from January 2008 to December 2017, and 221 cases from research databases before 2018 were retrospectively analyzed. The description of SCPA included stercoral perforation of the colon (SPC), idiopathic perforation of the colon (IPC) and spontaneous colonic perforation (SCP) in the study. All SCPA patients presented with unexplained abdominal pain and peritonitis. The median age was 62.5 years. The definite diagnosis preoperatively was 20.6%. The commonest lesion location was sigmoid colon and Hartmann’s operation accounted for 59.3%. Histopathology of stercoral perforation (HSP) and histopathology of idiopathic perforation (HIP) were two histopathological findings. Postoperative complication was 67.7% and mortality was 31.1%. Univariate and multivariate analyses showed that chronic constipation was an independent risk factor for histopathological features ( p ≤ 0.001, p = 0.005). Age of patients was associated with both postoperative complication ( p = 0.012, p = 0.044) and mortality ( p = 0.013, p = 0.034). Univariate analysis showed that HSP was associated with postoperative complication ( p = 0.015). Our findings from the analysis pertaining to SCPA confirm those from previous studies, supporting the SCPA, as a uniform description, is an infrequent and life-threatening disease requiring early surgical intervention. We found that the elderly with chronic constipation was a high-risk category and those with HIP had a more favorable outcome than that of patients with HSP.

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Section: Methodsmentioning

confidence: 99%

Spontaneous colonic perforation in adults: Evaluation of a pooled case series

et al. 2020

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“…Perforation of a carcinoma within a hernia is very rare, but mimics strangulation [17] and is associated with poor prognosis and a high recurrence risk [18]. Erythema and tenderness are signs of hernia strangulation, and also develop after tumour perforation within the sac, which may progress to necrotising fasciitis [17,19].…”

Section: Discussionmentioning

confidence: 99%

Colonic carcinoma presenting as strangulated inguinal hernia: report of two cases and review of the literature

2008

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Inguinal hernia and colonic carcinoma are common surgical conditions, yet carcinoma of the colon occurring within an inguinal hernia sac is rare. Of 25 reported cases, only one was a perforated sigmoid colon carcinoma in an inguinal hernia. We report two cases of sigmoid colon carcinoma, one of which had locally perforated. Each presented within a strangulated inguinal hernia. Oncologically correct surgery in these patients presents a technical challenge.

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“…The stool is more likely to stay in the rectosigmoid colon because of the narrowed colonic cavity. In addition, the smooth muscle contracts, which leads to an increase in pressure within the colonic cavity (6)(7)(8)(9).…”

Section: Discussion Discussionmentioning

confidence: 99%

Spontaneous Perforation of Sigmoid Colon Due to Chronic Constipation

Matsumoto¹,

Kawahara²,

Hiramoto³

et al. 2019

SGO

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Background/Aim: Spontaneous perforation of the sigmoid colon is defined as a sudden perforation of the normal colon in the absence of diseases. However, its etiology remains unclear. Methods: Between January 2010 and December 2017, twenty-three patients who underwent Hartmann's operative procedure with colostomy for acute peritonitis due to sudden perforation of the sigmoid colon at our hospital were enrolled in this study. Patients were divided into two groups according to the cause of the perforation (i.e., spontaneous perforation in seven and diverticulosis in sixteen). Results: All patients had a long history of chronic constipation. The mean age of the spontaneous group was 79.0 (71-87) years, which was significantly older than that of the diverticulosis group. Significant differences in gender, complication rates, or nutritional factors, such as body mass index, serum total protein, albumin, and cholinesterase, were not identified between the two groups. Although the lymphocyte counts of the spontaneous group were significantly lower than those of the diverticulosis group (p=0.029), significant differences were not identified in the neutrophil-to-lymphocyte ratio between the two groups. The diameters of the perforations in the spontaneous group were significantly larger than that of the diverticulosis group (p=0.046). Conclusion: Spontaneous perforation of the sigmoid colon due to chronic constipation may not be due to undernutrition but instead due to immune depression.

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An Unusual Perforation of the Colon: Report of Two Cases

Cited by 17 publications

References 9 publications

Spontaneous colonic perforation in adults: Evaluation of a pooled case series

Spontaneous colonic perforation in adults: Evaluation of a pooled case series

Colonic carcinoma presenting as strangulated inguinal hernia: report of two cases and review of the literature

Spontaneous Perforation of Sigmoid Colon Due to Chronic Constipation

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