Spontaneous cecal perforation in a 40-year-old pregnant woman treated by primary repair and omental patch: a case report

Kouam, Cyrille; Passang, Ouasso; Guifo, Marc-Leroy; Atem, Nkolaka

doi:10.1186/s13256-017-1336-x

Cited by 6 publications

(4 citation statements)

References 10 publications

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“…In cases of uncomplicated perforations and in the absence of severe inflammation, primary repair with omental patch can be considered otherwise right hemicolectomy is advised. No one technique has been proved superior in terms of final clinical outcome [ [8] , [9] , [10] ].…”

Section: Discussionmentioning

confidence: 99%

Idiopathic spontaneous cecal perforation: A rare pathology with high mortality

Al-Balas

Al-Wiswasy

2020

Annals of Medicine and Surgery

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Introduction Spontaneous perforation of the colon (SPC) is a rare disease characterized by sudden perforation of a clinically healthy colon in the absence of underlying disease or trauma. The aim of reporting this case is to highlight this surgical emergency in terms of clinical presentations, surgical management and outcomes. Presentation of case A 68 year-old male with history of diabetes mellitus, hypertension and chronic constipation on daily laxatives presented to the emergency department with a diffuse abdominal pain and distention for 4 days associated with vomiting and absence of defecation where he was prescribed phosphate rectal enemas. Patient was in sepsis with generalized abdominal tenderness and distention. Intraoperative findings of feculent peritonitis with isolated cecal perforation was identified, for which a right hemicolectomy with end ileostomy was performed. Discussion The first case was described in a woman presented with spontaneous rectum rupture by Brodie in 1827, with a less than 100 cases being reported in literature. In 1984, spontaneous perforations were classified into either “stercoral” or “idiopathic” perforations. More than 60% of colonic perforations were reported in the sigmoid or at the recto-sigmoid junction, mainly at the anti-mesenteric border, making spontaneous cecal perforation a very uncommon condition. Cecal perforation is associated with high mortality in the range of 30%–72%. Conclusion The outcome of SPC depends on multiple factors like onset of perforation, peritoneal contamination, and time of intervention. Regardless the surgical technique, early detection and surgical management are the main strategies associated with improving the outcomes.

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Section: Discussionmentioning

confidence: 99%

Idiopathic spontaneous cecal perforation: A rare pathology with high mortality

Al-Balas

Al-Wiswasy

2020

Annals of Medicine and Surgery

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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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“…In cases of severe inflammation, neoplasm, or indications of necrosis, a right hemicolectomy is recommended but is also associated with higher risks of morbidity and mortality [ 8 ]. Potential advantages to primary suture repair are a shortened postoperative stay, less blood loss, and lower risks for anastomosis breakdown [ 9 , 10 ]. Post-surgical outcome depends on time of onset, degree of perforation and peritoneal contamination, and the vital status of the patient.…”

Section: Discussionmentioning

confidence: 99%

Spontaneous Cecal Perforation During Pregnancy

Alshoubi,

Kim,

Hauter

et al. 2024

Cureus

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Spontaneous perforation of the colon is a rare disease defined as sudden perforation of a healthy colon without evidence of trauma or disease. These perforations are typically classified as either stercoral or idiopathic. Cecal perforation during pregnancy is an uncommon and potentially life-threatening condition requiring prompt recognition and surgical intervention. We present a case of a 33-year-old woman at 29 weeks and three days gestation presenting with spontaneous cecal perforation. She presented to the emergency department with diffuse abdominal pain and distention lasting for three days, associated with nausea and vomiting. Following evaluation, she was diagnosed with diffuse peritonitis. The diagnosis of this condition relies on both the clinical presentation and the utilization of radiographic imaging. The patient underwent an emergent explorative laparotomy with prompt surgical intervention to repair the 1.2 x 0.8 cm perforation found on her distended cecum. The surgical repair consisted of the excision of the edges and the primary suture of the perforation with an omental patch. Her post-procedure course was uneventful, and she later delivered a healthy baby at full term. This case highlights the importance of considering uncommon causes of acute abdominal pain in pregnant women to ensure timely diagnosis and management.

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Spontaneous cecal perforation in a 40-year-old pregnant woman treated by primary repair and omental patch: a case report

Cited by 6 publications

References 10 publications

Idiopathic spontaneous cecal perforation: A rare pathology with high mortality

Idiopathic spontaneous cecal perforation: A rare pathology with high mortality

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

Spontaneous Cecal Perforation During Pregnancy

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