Spontaneous Perforation of the Colon
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Submitted
October 19, 2021
Published
October 19, 2021
Abstract
Spontaneous colonic perforation is extremely rare. Several case reports and case series have been published on this topic in English literature. However, confusion still exists amongst General surgeons regarding its actual nomenclature. Different terminologies are used by many authors for these perforations i.e. spontaneous or idiopathic or stercoral. The aim of this topic is to make it clear to the surgeons about the difference between these types of perforations. This in turn will help them to have a better understanding of its exact terminology, diseases process and may guide them in the management of these patients.
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Key Words: Colonic perforation, spontaneous perforation, stercoral perforation, idiopathic perforation
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References
1. Yang B and Ni HK. Diagnosis and treatment of spontaneous colonic perforation: analysis of 10 cases. World J Gastroenterol 2008; 14: 4569–4572.
2. Chakravartty S, Chang A and Nunoo-Mensah J. A systematic review of stercoral perforation; Colorectal Dis 2013; 15: 930–935.
3. Berry J. Dilatation and rupture of sigmoid flexure short report. Br Med J 1894; 1: 301.12 Science Progress
4. Al Shukry S. Spontaneous perforation of the colon: clinical review of five episodes in four patients. omj, 24 (2009), pp. 137-141, 10.5001/omj.2009.30
5. Namikawa T, Ozaki S, Okabayashi T, Dabanaka K, Okamoto K, et al. (2011) Clinical characteristics of the idiopathic perforation of the colon. J Clin Gastroenterol 45: e82-6e86.
6. Tamai M, Satoh M and Tsujimoto A. Segmental muscular defects of the intestine: possible cause of spontaneous perforation of the bowel in adults. Hum Pathol 2013; 44: 2643–2650.
7. Losanoff JE, Basson MD, Khoury N, et al. Baffling perforation of the colon. Ulster Med J 2010; 79(1): 20–21.
8. Maurer CA, Renzulli P, Mazzucchelli L, et al. Use of accurate diagnostic criteria may increase incidence of stercoral perforation of the colon. Dis Colon Rectum 2000; 43:991–998.
9. Özbalci GS, Çinar H, Özbalc AB et al. Recurrent Spontaneous Colonic Perforation. Kolon Rektum Hast Derg 2015; 25:140-143
10. Kang J, Chung M. A stercoral perforation of the descending colon; J Korean Surg Soc. 2012; 82(2): 125-7.
11. Sandeep Bhat, Tanq P Azad, Manmeet Kaur, Spontaneous perforation of rectum with evisceration of small bowel stimulating intussusception, North AM J Med sciences 2010 (2) 596-597
12. Kasahara Y, Matsumoto H, Umemura H, Shirafa S, Kuyama T. Idiopathic perforation of the sigmoid colon in Japan. World J Surg 1981, 5: 125-130. http://dx.doi.org/10.1007/BF01657857
13. Islam S, Hosein D, Harnarayan P, Dan D. Idiopathic perforation of the transverse colon in an adult: a case report and literature review. Glob Surg, 1, September 2015, DOI: 10.15761/GOS.1000113
14. Chongxi R, Jinggang J,Yan S, Hongqiao W, Yan L, Fengshuo Y. Spontaneous colonic perforation in adults: Evaluation of a pooled case series. Science Progress, 2020, Vol. 103(3) 1–15. DOI: 10.1177/0036850420945462 journals.sagepub.com/home/sci
15. Kouam C, Passang O, Guifo ML and Atem N. Spontaneous cecal perforation in a 40-yearold pregnant woman treated by primary repair and omental patch: a case report. Journal of Medical Case Reports (2017) 11:162. DOI 10.1186/s13256-017-1336-x
16. Schwab K, Hamidi S, Chung A, J. Lim R, Khanlou N, Hoesterey D, Dumitras C, B. Adeyiga O, Tang PM, Wang TS, Saggar R, Goldstein J, Belperio JA, Dubinett SM, Kim JT, and Salehi-Rad R. Occult Colonic Perforation in a Patient With Coronavirus Disease 2019 After Interleukin-6 Receptor Antagonist Therapy. Open Forum Infectious Diseases; 9 September 2020. DOI: 10.1093/ofid/ofaa424
17. Goodman P and Dominguez R. Idiopathic colonic perforation in the neonate. Pediatr Emerg Care 1991; 7(1): 18–20.
18. Losanoff J and Kjossev K. Idiopathic perforation of sigmoid colon. Dig Dis Sci 1995; 40(6): 1408–1409
19. Ellul JPM, MannionsKhoury GA. Spontaneous rupture of the rectum with evisceration of the small intestine through the anus. Eur. J. Surg. 1995 (161) 925 – 927
20. Balmiki P, Dangi J, Garg N, Tyagi N. Idiopathic Spontaneous Perforation of the Rectum: A Case Report and Review of the Literature. OSR Journal of Dental and Medical Sciences (IOSR-JDMS) e-ISSN: 2279-0853, p-ISSN: 2279-0861.Volume 18, Issue 5 Ser. 14 (May. 2019), PP 12-14. DOI: 10.9790/0853-1805141214 www.iosrjournals.org 12 | Page
21. Gul YA, Waldron DJ, O’Connell PR. Stercoral perforation associated with parathyroid adenoma. Ir Med J 1997; 90(1): 20.
22. Avinoah E, Ovnat A, Peiser J, Charuzi I. Sigmoid perforation in patients with chronic constipation. J Clin Gastroenterol 1987; 9(1): 62-4.
23. Berney T, La Scala G, Vettorel D, Gumowski D, Hauser C, Frileux P, et al. Surgical pitfalls in a patient with type IV Ehlers-Danlos syndrome and spontaneous colonic rupture. Report of a case. Dis Colon Rectum 1994; 37(10): 1038-42.
24. Collins MH, Schwarze U, Carpentieri DF, Kaplan P, Nathanson K, Meyer JS, et al. Multiple vascular and bowel ruptures in an adolescent male with sporadic Ehlers- Danlos syndrome type IV. Pediatr Dev Pathol 1999; 2(1): 88-93.
25. Konishi T, Watanabe T, Kitayama J, Shibahara J, Hiramatsu T, Hara K, et al. Successfully treated idiopathic rectosigmoid perforation 7 years after renal transplantation. J Gastroenterol 2004; 39(5): 484-9.
26. Puglisi BS, Kauffman HM, Stewart ET, Dodds WJ, Adams MB, Komorowski RA. Colonic perforation in renal transplant patients; AJR Am J Roentgenol 1985; 145(3): 555-8. http://dx.doi.org/10.2214/ajr.145.3.555
27. Parish, K.L., Chapman, W.C. and Williams, L.F. Ischaemic Colitis: An Ever-Changing Spectrum? Annals of Surgery, 1991, (57), 118-121.
28. Gingold BS. Stercoral ulceration and perforation of colon secondary to narcotics abuse; Am J Proctol Gastroenterol Colon Rectal Surg 1981; 32(12): 5-6, 24.
29. Ervens J, Schiffmann L, Berger G, Hoffmeister B (2004) Colon perforation with acute peritonitis after taking clindamycin and diclofenac following wisdom tooth removal. J Craniomaxillofac Surg 32: 330-334.
30. Bunkar, SK, Singh, A, Singh, RP. Stercoral perforation of the sigmoid colon in a schizophrenic patient; J Clin Diagn Res 2015; 9(1): PD07–PD08
31. Cass AJ. Stercoral perforation: case of drug-induced impaction. Br Med J 1978; 2(6142): 932-3.
32. Yang, Y, Pan, K, Hikita, H, et al. Spontaneous perforation of the rectosigmoid colon: a report of 2 cases. Chin Med J (Engl) 2001; 114(4): 431–432
33. Basile, M., Montini, F., Cipollone, G. and Errichi, B.M. Spontaneous Perforations of the Large Intestine. AnnaliItaliani di Chirurgia, 1992, (63), 625-629.
34. Makki, A.M., Hejazi, S., Zaidi, N.H., Johari, A. and Altaf, A. Spontaneous Perforation of Colon: A Case Report and Review of Literature. Case Reports in Clinical Medicine, 2014, (3), 392-397.http://dx.doi.org/10.4236/crcm.2014.37087
35. Huttunen R, Heikkinen E, Larmi TK (1975) Stercoraceous and idiopathic perforations of the colon. Surg Gynecol Obstet 140: 756-760.
36. Serpell, J.W. and Nicholls, R.J. Stercoral Perforation of the Colon. British Journal of Surgery, 1990, (77), 1325- 1329.http://dx.doi.org/10.1002/bjs.1800771204
37. Kurane, SB, Kurane, BT. Idiopathic colonic perforation in adult-a rare case. Indian J Surg 2011; 73(1): 63–64.
38. Oguro S, Funabiki T, Hosoda K, et al. 64-slice multidector computed tomography evaluation of gastrointestinal tract perforation site: detectability of direct findings in upper and lower GI tract. Eur Radiol 2010; 20: 1396–1403.
39. Tanner TN, Hall BR and Oran J. Pneumoperitoneum. Surg Clin North Am 2018; 98: 915–932.
40. Maurer CA, Renzulli P, Mazzucchelli L, Egger B, Seiler CA, et al. (2000) Use of accurate diagnostic criteria may increase incidence of stercoral perforation of the colon. Dis Colon Rectum 43: 991-998.
41. Penna M, Markar SR, Mackenzie H, et al. Laparoscopic lavage versus primary resection for acute perforated diverticulitis: review and meta-analysis. Ann Surg 2018; 267(2): 252–258.
42. Gordon PH, Nivatvon S (2007) Principles and practice of surgery for colon, rectum and anus. Complications of colonic disease and their management; New York, USA: Informa Healthcare 1150-1151
43. Angenete E, Thornell A, Burcharth J, et al. Laparoscopic lavage is feasible and safe for the treatment of perforated diverticulitis with purulent peritonitis: the first results from the randomized controlled trial DILALA. Ann Surg 2016; 263: 117–122.
44. Thornell A, Angenete E, Bisgaard T, et al. Laparoscopic lavage for perforated diverticulitis with purulent peritonitis: a randomized trial. Ann Intern Med 2016; 164: 137–145.
45. Biondo S, Parés D, MartÃRagué J, De Oca J, Toral D, et al. (2002) Emergency operations for nondiverticular perforation of the left colon. Am J Surg 183: 256-260
46. Ryu CG, Kim P, Cho MJ, Shin M, Jung EJ. Clinical analysis of stercoral perforation without mortality; Dig Surg 2017; 34(3): 253-9
47. Laskin MD, Tessler K, Kives S. Cecal perforation due to paralytic ileus following primary caesarean section . J. Obstet. Gynaecol. Can., 31 (2009), pp. 167-171
2. Chakravartty S, Chang A and Nunoo-Mensah J. A systematic review of stercoral perforation; Colorectal Dis 2013; 15: 930–935.
3. Berry J. Dilatation and rupture of sigmoid flexure short report. Br Med J 1894; 1: 301.12 Science Progress
4. Al Shukry S. Spontaneous perforation of the colon: clinical review of five episodes in four patients. omj, 24 (2009), pp. 137-141, 10.5001/omj.2009.30
5. Namikawa T, Ozaki S, Okabayashi T, Dabanaka K, Okamoto K, et al. (2011) Clinical characteristics of the idiopathic perforation of the colon. J Clin Gastroenterol 45: e82-6e86.
6. Tamai M, Satoh M and Tsujimoto A. Segmental muscular defects of the intestine: possible cause of spontaneous perforation of the bowel in adults. Hum Pathol 2013; 44: 2643–2650.
7. Losanoff JE, Basson MD, Khoury N, et al. Baffling perforation of the colon. Ulster Med J 2010; 79(1): 20–21.
8. Maurer CA, Renzulli P, Mazzucchelli L, et al. Use of accurate diagnostic criteria may increase incidence of stercoral perforation of the colon. Dis Colon Rectum 2000; 43:991–998.
9. Özbalci GS, Çinar H, Özbalc AB et al. Recurrent Spontaneous Colonic Perforation. Kolon Rektum Hast Derg 2015; 25:140-143
10. Kang J, Chung M. A stercoral perforation of the descending colon; J Korean Surg Soc. 2012; 82(2): 125-7.
11. Sandeep Bhat, Tanq P Azad, Manmeet Kaur, Spontaneous perforation of rectum with evisceration of small bowel stimulating intussusception, North AM J Med sciences 2010 (2) 596-597
12. Kasahara Y, Matsumoto H, Umemura H, Shirafa S, Kuyama T. Idiopathic perforation of the sigmoid colon in Japan. World J Surg 1981, 5: 125-130. http://dx.doi.org/10.1007/BF01657857
13. Islam S, Hosein D, Harnarayan P, Dan D. Idiopathic perforation of the transverse colon in an adult: a case report and literature review. Glob Surg, 1, September 2015, DOI: 10.15761/GOS.1000113
14. Chongxi R, Jinggang J,Yan S, Hongqiao W, Yan L, Fengshuo Y. Spontaneous colonic perforation in adults: Evaluation of a pooled case series. Science Progress, 2020, Vol. 103(3) 1–15. DOI: 10.1177/0036850420945462 journals.sagepub.com/home/sci
15. Kouam C, Passang O, Guifo ML and Atem N. Spontaneous cecal perforation in a 40-yearold pregnant woman treated by primary repair and omental patch: a case report. Journal of Medical Case Reports (2017) 11:162. DOI 10.1186/s13256-017-1336-x
16. Schwab K, Hamidi S, Chung A, J. Lim R, Khanlou N, Hoesterey D, Dumitras C, B. Adeyiga O, Tang PM, Wang TS, Saggar R, Goldstein J, Belperio JA, Dubinett SM, Kim JT, and Salehi-Rad R. Occult Colonic Perforation in a Patient With Coronavirus Disease 2019 After Interleukin-6 Receptor Antagonist Therapy. Open Forum Infectious Diseases; 9 September 2020. DOI: 10.1093/ofid/ofaa424
17. Goodman P and Dominguez R. Idiopathic colonic perforation in the neonate. Pediatr Emerg Care 1991; 7(1): 18–20.
18. Losanoff J and Kjossev K. Idiopathic perforation of sigmoid colon. Dig Dis Sci 1995; 40(6): 1408–1409
19. Ellul JPM, MannionsKhoury GA. Spontaneous rupture of the rectum with evisceration of the small intestine through the anus. Eur. J. Surg. 1995 (161) 925 – 927
20. Balmiki P, Dangi J, Garg N, Tyagi N. Idiopathic Spontaneous Perforation of the Rectum: A Case Report and Review of the Literature. OSR Journal of Dental and Medical Sciences (IOSR-JDMS) e-ISSN: 2279-0853, p-ISSN: 2279-0861.Volume 18, Issue 5 Ser. 14 (May. 2019), PP 12-14. DOI: 10.9790/0853-1805141214 www.iosrjournals.org 12 | Page
21. Gul YA, Waldron DJ, O’Connell PR. Stercoral perforation associated with parathyroid adenoma. Ir Med J 1997; 90(1): 20.
22. Avinoah E, Ovnat A, Peiser J, Charuzi I. Sigmoid perforation in patients with chronic constipation. J Clin Gastroenterol 1987; 9(1): 62-4.
23. Berney T, La Scala G, Vettorel D, Gumowski D, Hauser C, Frileux P, et al. Surgical pitfalls in a patient with type IV Ehlers-Danlos syndrome and spontaneous colonic rupture. Report of a case. Dis Colon Rectum 1994; 37(10): 1038-42.
24. Collins MH, Schwarze U, Carpentieri DF, Kaplan P, Nathanson K, Meyer JS, et al. Multiple vascular and bowel ruptures in an adolescent male with sporadic Ehlers- Danlos syndrome type IV. Pediatr Dev Pathol 1999; 2(1): 88-93.
25. Konishi T, Watanabe T, Kitayama J, Shibahara J, Hiramatsu T, Hara K, et al. Successfully treated idiopathic rectosigmoid perforation 7 years after renal transplantation. J Gastroenterol 2004; 39(5): 484-9.
26. Puglisi BS, Kauffman HM, Stewart ET, Dodds WJ, Adams MB, Komorowski RA. Colonic perforation in renal transplant patients; AJR Am J Roentgenol 1985; 145(3): 555-8. http://dx.doi.org/10.2214/ajr.145.3.555
27. Parish, K.L., Chapman, W.C. and Williams, L.F. Ischaemic Colitis: An Ever-Changing Spectrum? Annals of Surgery, 1991, (57), 118-121.
28. Gingold BS. Stercoral ulceration and perforation of colon secondary to narcotics abuse; Am J Proctol Gastroenterol Colon Rectal Surg 1981; 32(12): 5-6, 24.
29. Ervens J, Schiffmann L, Berger G, Hoffmeister B (2004) Colon perforation with acute peritonitis after taking clindamycin and diclofenac following wisdom tooth removal. J Craniomaxillofac Surg 32: 330-334.
30. Bunkar, SK, Singh, A, Singh, RP. Stercoral perforation of the sigmoid colon in a schizophrenic patient; J Clin Diagn Res 2015; 9(1): PD07–PD08
31. Cass AJ. Stercoral perforation: case of drug-induced impaction. Br Med J 1978; 2(6142): 932-3.
32. Yang, Y, Pan, K, Hikita, H, et al. Spontaneous perforation of the rectosigmoid colon: a report of 2 cases. Chin Med J (Engl) 2001; 114(4): 431–432
33. Basile, M., Montini, F., Cipollone, G. and Errichi, B.M. Spontaneous Perforations of the Large Intestine. AnnaliItaliani di Chirurgia, 1992, (63), 625-629.
34. Makki, A.M., Hejazi, S., Zaidi, N.H., Johari, A. and Altaf, A. Spontaneous Perforation of Colon: A Case Report and Review of Literature. Case Reports in Clinical Medicine, 2014, (3), 392-397.http://dx.doi.org/10.4236/crcm.2014.37087
35. Huttunen R, Heikkinen E, Larmi TK (1975) Stercoraceous and idiopathic perforations of the colon. Surg Gynecol Obstet 140: 756-760.
36. Serpell, J.W. and Nicholls, R.J. Stercoral Perforation of the Colon. British Journal of Surgery, 1990, (77), 1325- 1329.http://dx.doi.org/10.1002/bjs.1800771204
37. Kurane, SB, Kurane, BT. Idiopathic colonic perforation in adult-a rare case. Indian J Surg 2011; 73(1): 63–64.
38. Oguro S, Funabiki T, Hosoda K, et al. 64-slice multidector computed tomography evaluation of gastrointestinal tract perforation site: detectability of direct findings in upper and lower GI tract. Eur Radiol 2010; 20: 1396–1403.
39. Tanner TN, Hall BR and Oran J. Pneumoperitoneum. Surg Clin North Am 2018; 98: 915–932.
40. Maurer CA, Renzulli P, Mazzucchelli L, Egger B, Seiler CA, et al. (2000) Use of accurate diagnostic criteria may increase incidence of stercoral perforation of the colon. Dis Colon Rectum 43: 991-998.
41. Penna M, Markar SR, Mackenzie H, et al. Laparoscopic lavage versus primary resection for acute perforated diverticulitis: review and meta-analysis. Ann Surg 2018; 267(2): 252–258.
42. Gordon PH, Nivatvon S (2007) Principles and practice of surgery for colon, rectum and anus. Complications of colonic disease and their management; New York, USA: Informa Healthcare 1150-1151
43. Angenete E, Thornell A, Burcharth J, et al. Laparoscopic lavage is feasible and safe for the treatment of perforated diverticulitis with purulent peritonitis: the first results from the randomized controlled trial DILALA. Ann Surg 2016; 263: 117–122.
44. Thornell A, Angenete E, Bisgaard T, et al. Laparoscopic lavage for perforated diverticulitis with purulent peritonitis: a randomized trial. Ann Intern Med 2016; 164: 137–145.
45. Biondo S, Parés D, MartÃRagué J, De Oca J, Toral D, et al. (2002) Emergency operations for nondiverticular perforation of the left colon. Am J Surg 183: 256-260
46. Ryu CG, Kim P, Cho MJ, Shin M, Jung EJ. Clinical analysis of stercoral perforation without mortality; Dig Surg 2017; 34(3): 253-9
47. Laskin MD, Tessler K, Kives S. Cecal perforation due to paralytic ileus following primary caesarean section . J. Obstet. Gynaecol. Can., 31 (2009), pp. 167-171
Authors
Islam , MBBS, DM, FACS, FASBrS, FCCS, S. . (2021). Spontaneous Perforation of the Colon . Journal of Medical Care Research and Review, 4(10). Retrieved from https://mcrr.info/index.php/mcrr/article/view/197
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