Stercoral Ulcer-Associated Perforation and Chemotherapy

Mouchli, Mohamad; Meehan, Anne M.

doi:10.1159/000475756

Cited by 4 publications

(2 citation statements)

References 16 publications

(17 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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“…In that study, the median value of serum albumin in the cohort was 3.3 g/dL, which suggests that there were fewer patients with malnutrition than in our cohort. Malnutrition and impaired activity of daily living (ADL), which are known risk factors for rectal ulcers [ 23 , 24 ], may explain why rectal ulcers were the most common cause of haematochezia in hospitalized patients.…”

Section: Discussionmentioning

confidence: 99%

Clinical Characteristics and Outcomes of Hospital-Acquired Lower Gastrointestinal Bleeding: A Single Centre Retrospective Cohort Study

Someko¹,

Shimura²,

Tsujimoto³

et al. 2022

Cureus

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BackgroundLower gastrointestinal bleeding (LGIB) is common in inpatient and outpatient settings; however, there are limited studies on the clinical characteristics and patient outcomes of those with hospital-acquired LGIB. MethodsWe performed a retrospective cohort study of patients with hospital-acquired LGIB who underwent colonoscopy during hospitalization between January 2017 and December 2021. We described the clinical characteristics, etiology, and clinical outcomes of patients stratified as those undergoing colonoscopy within 24 hours from haematochezia onset (early colonoscopy group) or after 24 hours from onset (late colonoscopy group). We used multivariable logistic regression to identify factors associated with endoscopic intervention in the early and late colonoscopy groups. ResultsOf the 272 patients included, the median age was 79 years (interquartile range: 72-85 years), 153 (56%) were bedridden, and 172 (63%) had hypoalbuminemia. The most frequent etiology was rectal ulcer (101 cases, 37%), whereas 7 (2.6%) had diverticular bleeding. The endoscopic intervention was performed on 16.7% and 7.9% of early and late colonoscopy patients. There were more patients with both non-severe and severe rebleeding in the early colonoscopy group (16% and 12%, respectively) than in the late colonoscopy group (11% and 6.5%, respectively). Colonoscopy-on-worktime was the only factor independently associated with a higher occurrence of endoscopic intervention. ConclusionsIn our sample, very old patients with hospital-acquired LGIB required endoscopy mainly due to rectal ulcers. Further studies will be necessary to investigate the differences between community-acquired LGIB and hospital-acquired LGIB and the optimal timing of colonoscopy for these patients.

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Stercoral Ulcer-Associated Perforation and Chemotherapy

Cited by 4 publications

References 16 publications

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

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

Clinical Characteristics and Outcomes of Hospital-Acquired Lower Gastrointestinal Bleeding: A Single Centre Retrospective Cohort Study

Multiple drugs

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