Stercoral Ulcer and Colonic Perforation in an Individual with Parkinson's Disease with Constipation

Tateno, Fuyuki; Sakakibara, Ryuji; Aiba, Yosuke; Tsuyusaki, Yohei; Kusumoto, Masahiko; Tateno, Hiromi; Ogata, Tsuyoshi

doi:10.1111/jgs.14357

Cited by 7 publications

(4 citation statements)

References 11 publications

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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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“…Rare, but potentially life-threatening, complications of chronic constipation include megacolon complicated by sigmoid volvulus 32 and stercoral ulceration leading to perforation. 33…”

Section: Clinical Impactmentioning

confidence: 99%

“…Using this strategy may avoid silent progression to impaction, megacolon, and perforation. 32,33,[87][88][89][90]…”

Section: Management Of Bowel Dysfunction In Pdmentioning

confidence: 99%

Constipation in Parkinson's Disease

Quigley

2023

Semin Neurol

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Constipation is one of the most common gastrointestinal features of Parkinson's disease (PD), occurring in over 50% of all PD patients during the course of their disease. Furthermore, constipation is now recognized as an important, prodromal symptom and may predate the onset of the classical motor symptoms by decades. Thereafter, the prevalence and severity of constipation in PD tend to parallel the course of both motor and nonmotor phenomena such as cognitive decline and depression. Difficult defecation (obstructed defecation, dyssynergia) is the primary pathophysiology underlying constipation and likely reflects involvement by the PD process of one or more of the many skeletal muscle groups that are involved in effecting defecation. Management of constipation in PD may be complicated by several patient factors including dysphagia, cognitive impairment, depression, and weak sphincter tone. While the armamentarium available to those who treat constipation, in general, has expanded considerably in recent years, the evidence supporting any therapy in the management of this symptom in PD has remained slim.

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“…Even though, Most of the literature points to chronic constipation as the primary cause for Stercoral perforation, they have reported high risk in patients with Parkinson's suffering from constipation [8]. Use of narcotics [9], anticholinergic drugs [10], Nonsteroidal anti-in lammatory drugs (NSAID'S) [11], Patients undergoing chemotherapy [12], Ehlers-Danlos syndrome [13], Cushing's disease [14] and Psychiatric patients on Anti-Psychotic medications [15].…”

Section: Introductionmentioning

confidence: 99%