Sigmaperforation mit lokaler Peritonitis durch indirektes Trauma - Fallbericht und Literatur�bersicht

Abstract

Injuries to the sigmoid occur either as acute or protracted events. In the first case, enteral contents discharge into the abdominal cavity and a generalized, fecal, life-threatening peritonitis with a bad prognosis develops. In the protracted form, the rupture is covered by peritoneum and adherent organs before perforation. The ensuing abscess formation may lead to perforation into contiguous visceral organs or the cutis. Frequently an intestinal or cutaneous fistula results. The trigger for a sigmoid perforation can be a spontaneous rupture in an already vulnerable intestine. Common precursory diseases are diverticulitis, colitis, carcinomas, and necroses. Also, elevated intestinal pressure invoked by increased bearing down or coproliths may cause disruption. Diagnostic procedures such as rectoscopy and rectal contrast instillation are frequent idiopathic causes of traumatic injuries to the sigmoid. Perforating injuries of the abdominal cavity by stabbing, gunshot, or impalement may affect the sigmoid and open its lumen. Foreign bodies often lead to traumatic injuries of the rectosigmoid junction. In contrast, indirect trauma as a cause of sigmoid perforation, which is described in the following case, is very rare. A 62-year-old woman,who had a cholecystectomy and adhesive strangulation of intestine in her history, was admitted to our clinic after falling down stairs and landing on her bottom. She suffered a sigmoid rupture and peritonitis. Laparotomy and suturing of the sigmoid defect were performed.

Rectal impalement by pirate ship: A case report

“…Most reported mechanisms are a fall from height, 4,5,6,7,10,21,22 gunshot injuries, stab wounds, sexual abuse, unusual sexual acts and iatrogenic injury (endoscopy, thermometers, etc.). 1,8,9,14,15,18,20 The self-introduction of foreign bodies into the rectum is however, not rare, although fortunately this seldom results in a perforation. The most striking report noted in the literature of self induced rectal perforation involved a 50-year-old man who inserted a live eel in his rectum to relieve constipation.…”

Colonic Perforation in a Young Tetraplegic Male Caused by Zucchini

“…Perforation of the colon can be explained by any number of causes, most often carcinoma, inflammatory bowel disease, iatrogenic perforation, penetrating or blunt abdominal trauma, but also by foreign bodies in alimentary tract (5, 6, 7). The risk of undesired consequences such as perforation is in positive correlation with length and sharpness of the object (1).…”