Spontaneous Perforation of Colon: A Case Report and Review of Literature

Makki, Ahmed; Hejazi, Soha; Zaidi, Nisar; Johari, Adel

doi:10.4236/crcm.2014.37087

Cited by 5 publications

(17 citation statements)

References 16 publications

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“…Colonic perforations resulting in severe peritonitis are uncommon and could be the result of appendicitis, diverticulitis, neoplasms, or acute pseudo-obstruction (Ogilvie syndrome) [ 4 ]. Spontaneous perforations of the colon are scarce and are defined as sudden perforation of an apparently healthy colon in the absence of any other disease or injury [ 1 ]. Spontaneous cecal perforations are even more uncommon [ 6 ].…”

Section: Discussionmentioning

confidence: 99%

“…The ileocecal region is one of the vulnerable anatomic points of the colonic vasculature as well as the splenic flexure (Griffiths point) and the rectosigmoid region (Sudeck point) [ 1 ]. The cecum is more susceptible to perforation, owing to its thin wall and its large diameter, allowing it to expand three times more than other areas of the colon.…”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

“…Spontaneous perforation of the colon is defined as a sudden perforation of an apparently healthy colon in the absence of any other disease or injury. Fewer than 100 cases have been reported in the literature to date [ 1 ]. More than 60% of these perforations occur in the sigmoid colon, making spontaneous cecal perforation a very uncommon condition [ 1 , 2 ].…”

Section: Introductionmentioning

confidence: 99%

“…Fewer than 100 cases have been reported in the literature to date [ 1 ]. More than 60% of these perforations occur in the sigmoid colon, making spontaneous cecal perforation a very uncommon condition [ 1 , 2 ]. The latter is difficult to assess prior to surgery and is even more difficult in a pregnant patient, owing to the peculiar anatomic and physiologic features of pregnancy and the restrictions imposed on diagnostic imaging techniques such as radiography and computed tomography (CT) [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

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

Kouam

Passang²,

Guifo

et al. 2017

J Med Case Reports

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BackgroundSpontaneous colonic perforations are scarce, and cecal perforations even more so. Preoperative diagnosis of the latter in a pregnant woman is particularly difficult because of physiologic changes and restrictions on some diagnostic imaging techniques, such as X-rays. Furthermore, management of these patients is a big challenge.Case presentationWe present a case of a spontaneous cecal perforation in a 40-year-old pregnant black woman in the Regional Hospital of Bafoussam in Cameroon. The results of clinical examination and ultrasonography on admission were in line with acute generalized peritonitis in a woman at 20 weeks of a viable pregnancy, indicating an urgent laparotomy. Operative findings were a 1 × 1-cm perforation on a distended cecum with minimal fecal contamination. The treatment consisted of excision of the edges, primary suture of the perforation, and omentoplasty. The recovery of the patient was uneventful.ConclusionsThe management of spontaneous cecal perforation in a pregnant woman was a big challenge. The perforation was repaired by primary suture and omentoplasty. Further studies comparing this approach with right hemicolectomy are recommended.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

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

Kouam

Passang²,

Guifo

et al. 2017

J Med Case Reports

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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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