Perforation of the cecum resulting from a closed-loop obstruction in a patient with an adenocarcinoma of the sigmoid colon: a case report

Toledo, Jefferson Sing; Correia, Marley Moreira; Coutinho, Rafael Rodrigues; Kifer, Eduardo Fukamachi; Torres, Diego de Faria Magalhães

doi:10.1016/j.ijscr.2017.05.021

Cited by 7 publications

(10 citation statements)

References 12 publications

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“…Partial obstruction of the colon, peritoneal dissemination, or intestinal perforation leading to generalized peritonitis could cause severe abdominal pain and acute abdomen. Because of the fact that colorectal cancer is a wasting syndrome with severe symptoms including nausea, vomiting, constipation, before the bowel lumen becomes completely obstructed, perforation of the colon is a rare condition and occurs mostly in elderly ( 10 ). These symptoms with an adnexal mass finding on imaging easily cause a confusion for the diagnosis of tuboovarian abscess.…”

Section: Discussionmentioning

confidence: 99%

Sigmoid Colon Perforation Mimics a Tuboovarian Absces

et al. 2018

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IntroductionAn adnexal mass may be diagnosed after a routine pelvic ultrasonographic examination or an emergent hospital admission due to rupture of ectopic pregnancy, adnexal torsion or rupture of tuboovarian abscess. It is necessary to evaluate the origin of the mass initially and to classify patients who need further evaluation and treatment for an urgent condition.Case presentationWe report a case of sigmoid colon rupture due to sigmoid colon adenocarcinoma presenting as acute abdomen with left adnexal mass in a 28 years old woman. Abdominopelvic computed tomography revealed a left adnexal mass with suspicion of tuboovarian abscess. In laparatomy, rupture of sigmoid colon was observed and resection of sigmoid colon was performed. Histological examination of resection part revealed diagnosis of sigmoid colon adenocarcinoma due to familial adenomatous polyposis.ConclusionThis case may be interesting for clinicians because pelvic pain, fever, increased infection markers in the laboratory and mass at ultrasonography or other screening methods could cause a misdiagnosis of tubaovarian abscess especially in reproductive age women. Before the operation of the pelvic mass of all age women with the diagnosis of tuboovarian abscess other causes of the pelvic abscess should come into mine and necessary preparation for operation must be done.

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Section: Discussionmentioning

confidence: 99%

Sigmoid Colon Perforation Mimics a Tuboovarian Absces

et al. 2018

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“…The subsequent perforation will cause fecal peritonitis and will accordingly increase the rates of morbidity and mortality in such cases. Cecal perforation will be found most often on the anterior longitudinal axis (unlike in our case), with sharp uninflamed margins [13].…”

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confidence: 61%

“…aureus, E. coli, Bacteroides species, or other rare bacteria, such as the Actinomyces species [16]. Since cecum (in the case of distal obstructing cancer) usually perforates most often on the anterior longitudinal axis [13], it is not surprising that there is only one more case report of a retroperitoneal diastatic cecal perforation, which manifested however as subcutaneous cervical emphysema and pneumomediastinum, and not as a retroperitoneal abscess [17].…”

Section: Case Reports In Surgerymentioning

confidence: 99%

“…Risk factors heralding the progression of the ischemic changes to frank perforation include a cecal diameter of 12 cm, a long-standing dilation, and an intraluminal pressure greater than 80 mmHg. Additionally, a closed-loop bowel obstruction may only occur in the presence of a competent ileocecal valve, which barium studies have exhibited in only 10-30% of the tested population [13].…”

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confidence: 99%

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Retroperitoneal Cecal Perforation Resulting from Obstructive Ascending Colon Adenocarcinoma

Paramythiotis

Karakatsanis

Moysidis

et al. 2020

Case Reports in Surgery

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Most colorectal cancer patients in the early stages of the disease do not display any alarming symptoms. A total percentage of 9-27% of colorectal cancer patients present with acute abdomen, bowel obstruction, perforation, or bleeding. Perforation as the first presentation of the disease is seen in no more than 2.6-10% of patients. Intestinal perforation may be found on either the site of the tumor or on a more proximal site, caused by distention of the bowel due to peripheral obstruction. This is a case of a 75-year-old female patient who presents in the emergency department with retroperitoneal cecal perforation due to an obstructing tumor of the ascending colon. She underwent an emergency right hemicolectomy and washout of the retroperitoneal space. The cecum is not an unusual site of distention and subsequent perforation in the case of colonic obstruction, especially in the presence of a competent ileocecal valve. While the mechanism of diastatic cecal perforation is well described, it is the first time in the literature that this does not occur on the anterior surface of the organ. In our case, cecal perforation presents as a retroperitoneal abscess without peritoneal spillage. Nonetheless, it still carries a grim prognosis and urgent surgical intervention is needed.

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“…Our patient had both obstruction and perforation, similar to the patient in the Siddiq et al [ 13 ] study, but our patient’s case was comparable to other case reports in which only one of obstruction, perforation, impaction, and penetration was the dominant pathology [ 9 – 14 ]. This process might be due to excessive dilation of the duodenum due to the progression of bowel obstruction, which results in fragility of the intestinal wall and leads to perforation and even the generation of peritonitis [ 18 ].…”

Section: Discussionmentioning

confidence: 99%

Duodenal obstruction due to accidental swallowing of a dental prosthesis: a case report and review of the literature

2020

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Background Artificial dentures are the most common object ingested by elderly patients and account for 4–18% of all foreign body ingestions. Denture impaction in the small bowel is a rare phenomenon. Surgery of the duodenum is difficult, so endoscopy should be the first choice in these patients. There are very rare case reports on denture ingestion-induced duodenal obstruction or perforation, so the aim of this publication was to show a rare case of accidental ingestion of a dental prosthesis with duodenal obstruction and also perforation that could not be treated with endoscopic management and was managed with duodenal kocherization and gastrostomy. Case presentation A 47-year-old Iranian woman presented to our hospital with epigastric abdominal pain of 2 hours’ duration after the accidental ingestion of a dental prosthesis 2 days before admission. The patient had severe epigastric tenderness. Radiographic examination revealed nothing. Upper gastrointestinal endoscopy showed a swallowed lodged denture in the second to third parts of the duodenum, and the attempt to extract the denture failed. The patient underwent laparotomy and duodenal kocherization, pushing the denture to the stomach, and gastrostomy, and the denture was brought out without any complications. Conclusions Patients with old and worn dentures should have their prosthesis reconstructed and redesigned periodically in order to prevent denture ingestion and its complications. Early surgical intervention is recommended in patients with failed endoscopic extraction of foreign bodies and in those with duodenal perforation.

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Perforation of the cecum resulting from a closed-loop obstruction in a patient with an adenocarcinoma of the sigmoid colon: a case report

Cited by 7 publications

References 12 publications

Sigmoid Colon Perforation Mimics a Tuboovarian Absces

Sigmoid Colon Perforation Mimics a Tuboovarian Absces

Retroperitoneal Cecal Perforation Resulting from Obstructive Ascending Colon Adenocarcinoma

Duodenal obstruction due to accidental swallowing of a dental prosthesis: a case report and review of the literature

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