CRCM  Vol.3 No.7 , July 2014
Spontaneous Perforation of Colon: A Case Report and Review of Literature
ABSTRACT

Objective: To present a case of spontaneous perforation of colon. Introduction: Spontaneous perforation of colon (SPC) is defined as sudden perforation of apparently healthy colon in absence of diseases or injury. SPC is an uncommon clinical entity which is seldom reported in literature, less than 100 cases were reported. Case report: A 82-year-old gentleman presented to emergency room (ER) with acute abdominal pain, for few hours duration. Pain started paraumbilically with sudden onset and then with increasing intensity became generalized. It was associated with nausea and vomiting. On general examination, he was conscious, alert. His vital signs: afebrile, pulse: 106/m, B.P: 140/100, local examination showed generalized abdominal tenderness & guarding with absent intestinal sounds. P.R. exam showed remnants of stool with blood stain on gloves, no masses. Computerized tomography (CT) abdomen showed perforation of cecum. He was taken to operation room (OR) and right hemicolectomy was done. Post operative period was uneventful and he was discharged in good health. Conclusion: SPC is a serious condition with high morbidity and mortality due to delay in diagnosis and management so, every effort should be made to make diagnosis especially in elderly and prompt surgical intervention should be done.


Cite this paper
Makki, A. , Hejazi, S. , Zaidi, N. , Johari, A. and Altaf, A. (2014) Spontaneous Perforation of Colon: A Case Report and Review of Literature. Case Reports in Clinical Medicine, 3, 392-397. doi: 10.4236/crcm.2014.37087.
References
[1]   Yang, B. and Ni, H.K. (2008) Diagnosis and Treatment of Spontaneous Colonic Perforation: Analysis of 10 Cases. World Journal of Gastroenterology, 14, 4569-4572.
http://dx.doi.org/10.3748/wjg.14.4569

[2]   Ni, H.-K. (2008) How to Diagnose and Treat Spontaneous Colonic Perforation? Health & Medicine.

[3]   Zachariah, S.K. and Raja, N. (2010) Spontaneous Perforation of the Colon and Hypothyroidism: Report of a Case and Review of Literature. Gastroenterology Research, 3, 147-149.

[4]   Sheikholeslami, F. (2009) Spontaneous Perforation of Rectosigmoid Colon. Iranian Journal of Medical Sciences, 1.

[5]   Kim, E.S. and Brandt, M.L. (2013) Spontaneous Intestinal Perforation of the Newborn.

[6]   Al Shukry, S. (2009) Spontaneous Perforation of the Colon Clinical Review of Five Episodes in four Patients. OMJ, 24, 137-141.

[7]   Galanis, I., Dragoumis, D., Kalogirou, T., Lakis, S. and Kotakidou, R. (2010) Spontaneous Perforation of Solitary Ulcer of Transverse Colon. Indian Journal of Pathology & Microbiology, 53, 138.

[8]   Puglisi, B.S., Kauffman, H.M., Stewart, E.T., Dodds, W.T., Adams, M.B. and Komorowski, R.A. (1985) Colonic Perforation in Renal Transplant Patients. AJR. American Journal of Roentgenology, 145, 555-558.
http://dx.doi.org/10.2214/ajr.145.3.555

[9]   Fuchs, J.R. and Fishman, S.J. (2004) Management of Spontaneous Colonic Perforation in Ehlers-Danlos Syndrome Type IV. Journal of Pediatric Surgery, 39, e1-e3.

[10]   Kumar, A., Griwan, M.G. and Naresh, P. (2013) Spontaneous Colonic Perforation—Rare Presentation. Journal of Surgical Academia, 3.

[11]   Maurer, C.A., Renzulli, P., Mazzucchelli, L., Egger, B., Seiler, C.A. and Buchler, M.W. (2000) Use of Accurate Diagnostic Criteria May Increase Incidence of Stercoral Perforation of the Colon. Diseases of the Colon Rectum, 43, 991-998.
http://dx.doi.org/10.1007/BF02237366

[12]   Cho, H., Han, H.Y., Chun, T.J., Yu, I.K., Daejon, K.R., Daejeon, K.R. and Daejeon, R. Spontaneous Perforation of the Colon: CT Findings and Clinical Characteristics. Poster Type: Scientific Exhibit ECR 2012.

[13]   Kasahara, Y., Matsumoto, H., Umemura, H., Shiraga, S. and Kuyama, T. (1981) Idiopathic Perforation of the Sigmoid Colon in Japan. World Journal of Surgery, 5, 125-130.
http://dx.doi.org/10.1007/BF01657857

[14]   Chen, J.-C., Chen, C.-C., Liang, J.-T. and Huang, S.-F. Spontaneous Bowel Perforation in Infants and Young Children: A Clinicopathologic Analysis of Pathogenesis. Journal of Pediatric Gastroenterology & Nutrition, 30, 432-435.

[15]   Siddharth, P. and Ravo, B. (1988) Colorectal Neurovascular and Anal Sphincter. Surgical Clinics of North America, 68, 1185-1200.

[16]   Serpell, J.W. and Nicholls, R.J. (1990) Stercoral Perforation of the Colon. British Journal of Surgery, 77, 1325-1329.
http://dx.doi.org/10.1002/bjs.1800771204

[17]   Basile, M., Montini, F., Cipollone, G. and Errichi, B.M. (1992) Spontaneous Perforations of the Large Intestine. Annali Italiani di Chirurgia, 63, 625-629.

[18]   Velitchkov, N.G., Kjossev, K.T., Losanoff, J.E., Grigorov, G.I. and Kavardjikova-Milanova, V.A. (1995) Stercoral Perforation of the Colon. Rozhl Chir, 74, 145-146.

[19]   Xu, B., Shao, W.D., Shen, H.W. and Wang, Q.B. (2004) Emergence Treatment of Idiopathic Rupture of Sigmoid Colon. Zhonghua Jizhen Yixue Zazhi, 13, 564-566.

[20]   Parish, K.L., Chapman, W.C. and Williams, L.F. (1991) Ischaemic Colitis: An Ever-Changing Spectrum? Annals of Surgery, 57, 118-121.

[21]   Kalayc1, M., Özder, A. and Toprak, D. (2011) Spontaneous Colon Perforation Due to Fecal Impaction. SETB, 45, 134-137.

[22]   Barlemeo, R.S., Calabrese, P.R., Howard, D.R. and Taubin, L. (1977) Spontaneous Perforation of the Colon a Potential Complication of Chronic Renal Failure. The American Journal of Digestive Diseases, 22.

[23]   Konishi, T., Watanabe, T., Kitayama, J., Shibahara, J., Hiramatsu, T., Hara, K., et al. (2004) Successfully Treated Idiopathic Recto Sigmoid Perforation 7 Years after Renal Transplantation. Journal of Gastroenterology, 39, 484-489.
http://dx.doi.org/10.1007/s00535-003-1319-0

[24]   Ervens, J., Schiffmann, L., Berger, G. and Hoffmeister, B. (2004) Colon Perforation with Acute Peritonitis after Taking Clindamycin and Diclofenac Following Wisdom Tooth Removal. Journal of Cranio-Maxillo-Facial Surgery, 32, 330-334.
http://dx.doi.org/10.1016/j.jcms.2004.05.007

[25]   Kashtan, H., Goldman, G., Stadler, J., Werbin, N., Baratz, M. and Wiznitzer, T. (1986) Recurrent Spontaneous Perforation of the Colon. Diseases of the Colon Rectum, 29, 586-587.
http://dx.doi.org/10.1007/BF02554265

[26]   Grosfeld, J.L., Molinari, F., Chaet, M., et al. (1996) Gastrointestinal Perforation and Peritonitis in Infants and Children: Experience with 179 Cases over Ten Years. Surgery, 120, 650-656.
http://dx.doi.org/10.1016/S0039-6060(96)80012-2

[27]   Li, M.J., Xiang, J.B. and Chen, L.L. (2001) Emergency Treatment for Colonic Perforation (29 Patients Reported). Zhongguo Linchuang Yixue, 11.

[28]   Huang, W.S., Wang, C.S., Hsieh, C.C., Lin, P.Y., Chin, C.C. and Wang, J.Y. (2006) Management of Patients with Stercoral Perforation of the Sigmoid Colon: Report of Five Cases. World Journal of Gastroenterology, 12, 500-503.

[29]   Spiliotis, J. (2008) Idiopathic Spontaneous Perforation of the Sigmoid Colon or a Complication of Sexual Activity? World Journal of Gastroenterology.

 
 
Top