Broken beer bottle as a cause of sigmoid perforation: A summary of causes and predictors in the management of traumatic and non-traumatic colorectal perforation

Abstract

Introduction and importance The presence of foreign bodies at the colorectal level and associated complications is a problem that has become increasingly common in emergency departments. This condition carries high health costs, in addition to having high morbidity and mortality rates, due to the large number of complications such as perforation. Case presentation 46-year-old male patient, who came to the emergency department of a low-level hospital with a clinical picture of approximately one day of evolution consisting of the violent introduction of a foreign body (bottle) at the anorectal level secondary to aggression in a fight, with subsequent endoluminal rupture. Clinical discussion The most recent evidence indicates that the incidence of perforation as a complication of colorectal foreign body introduction is low. However, the presence of profuse bleeding, advanced age, presence of comorbidities and sepsis are predictors of poor prognosis in these cases. In general, perforation secondary to non-traumatic causes is more frequent, being predominantly due to colorectal cancer, ischemia, diverticulitis, inflammatory bowel disease, inadequate use of enema, iatrogenic endoscopy or anorectal manometry or fecal impaction. The presence of unfavorable factors prolongs hospital stay, the risk of reoperation, perianal infection, peritonitis, sepsis and wound infection, generating mortality rates of up to 38%. Conclusion Colorectal perforation is more frequent in non-traumatic situations and carries health costs and risk of mortality. Its management depends on hospital aspects, clinical context of the patient and training of health personnel. However, most of the outcomes are favorable.

Anorectal manometry after rectal surgery: a case report with rectal bleeding and perforation

“…Combined with the results of the whole abdominal CT, it was concluded that it was unlikely that the rectal bleeding and perforation would heal spontaneously. Further, it has been reported that adverse factors, such as advanced age, comorbidities, and excessive bleeding, may increase the risk of peritonitis and sepsis, prolong patient hospitalization, and increase mortality ( 11 ). Thus, we first performed active surgery and successfully treated this patient who was suffering from ARM-induced rectal bleeding and perforation after rectal surgery without any complications.…”