The tip of the iceberg of colorectal perforation from enema: a systematic review and meta-analysis

Broken beer bottle as a cause of sigmoid perforation: A summary of causes and predictors in the management of traumatic and non-traumatic colorectal perforation

“…The most recent evidence indicates that the incidence of perforation as a complication of colorectal foreign body introduction is low [7] , [9] , [14] , [15] , [16] . However, the presence of profuse bleeding, advanced age, presence of comorbidities and sepsis are predictors of poor prognosis in these cases [7] , [9] , [14] , [15] , [16] .…”

“…The most recent evidence indicates that the incidence of perforation as a complication of colorectal foreign body introduction is low [7] , [9] , [14] , [15] , [16] . However, the presence of profuse bleeding, advanced age, presence of comorbidities and sepsis are predictors of poor prognosis in these cases [7] , [9] , [14] , [15] , [16] . In general, perforation secondary to non-traumatic causes is more frequent, being predominantly due to colorectal cancer, ischemia, diverticulitis, inflammatory bowel disease, inadequate use of enema, iatrogenic endoscopy or anorectal manometry or fecal impaction [6] , [7] , [9] , [10] , [11] , [12] , [13] , [14] .…”

“…However, the presence of profuse bleeding, advanced age, presence of comorbidities and sepsis are predictors of poor prognosis in these cases [7] , [9] , [14] , [15] , [16] . In general, perforation secondary to non-traumatic causes is more frequent, being predominantly due to colorectal cancer, ischemia, diverticulitis, inflammatory bowel disease, inadequate use of enema, iatrogenic endoscopy or anorectal manometry or fecal impaction [6] , [7] , [9] , [10] , [11] , [12] , [13] , [14] . Favorable prognostic factors for a satisfactory outcome in both traumatic and non-traumatic causes are early initiation of surgery and care in a specialized surgical center [6] , [12] .…”

“…Favorable prognostic factors for a satisfactory outcome in both traumatic and non-traumatic causes are early initiation of surgery and care in a specialized surgical center [6] , [12] . The unfavorable prognostic factors are advanced age, requirement of mechanical ventilation, prolonged stay in hospital and intensive care unit, APACHE II (Acute Physiology and Chronic Health Evaluation II) score between 8 and 30, SOFA (Sequential Organ Failure Assessment) score between 0 and 12, DIC (Disseminated Intravascular Coagulation) score between 0 and 8, POSSUM (Physiological and Operative Severity Score for the Enumeration of Mortality and Morbidity) score between 34 and 74, CT (Computerized Tomography) dirty mass volume in cm 3 (234 ± 211), presence of profuse bleeding, use of conservative treatment, performance of primary anastomosis without a diverting stoma, ASA Grade 3, 4 or 5, chronic steroid use, serum creatinine level > 3.0 mg/dL, disseminated cancer, white blood cell count <3500/mL, low preoperative systolic blood pressure and Hinchey classification IV [6] , [7] , [8] , [9] , [10] , [11] , [12] , [13] , [14] , [15] , [16] , [17] . Dirty mass is a little-known concept that represents the finding of focal collection of extraluminal fecal matter [19] .…”

“…We excluded those articles that did not present data on causes, predictors and outcomes of colorectal perforation, as well as those that did not have full text available. After the application of these criteria, 12 studies were finally included [6] , [7] , [8] , [9] , [10] , [11] , [12] , [13] , [14] , [15] , [16] , [17] . This case report followed the SCARE guidelines for its realization [18] .…”