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Int J Surg Case Rep. 2013;4(11):1038-40. doi: 10.1016/j.ijscr.2013.09.005. Epub 2013 Sep 16.

Stercoral perforation of the colon in sigmoid colostomy patients: Two case reports.

Author information

  • 1Department of Surgery, Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea.

Abstract

INTRODUCTION:

Stercoral perforation of the colon has rarely been reported. Only 3 cases of stercoral perforation of the colon proximal to an end colostomy have been reported. We present two cases of stercoral perforation of the colon in end colostomy patients.

PRESENTATION OF CASE:

A 70-year-old man who had undergone abdomino-perineal excision for anal cancer was referred for left lower quadrant pain and fever. Stercoral perforation was discovered along the distal descending colon, proximal to the end sigmoid colostomy. The patient underwent segmental resection of the colon and revision of the stoma and was discharged on postoperative day 32. A 71-year-old woman who had undergone abdomino-perineal excision for distal rectal cancer with preoperative chemoradiation presented fever with 2 days of low abdominal pain. The patient had sacral bone and lung metastases from rectal cancer and suffered from chronic constipation. Stercoral perforation was found around the sigmoid colon, just proximal to the end sigmoid colostomy. The patient underwent simple repair of the perforated colon through the parastomal incision. On postoperative day 8, leakage occurred at the repair site. Segmental resection of the colon and revision of the stoma were performed. She was discharged 44 days after the initial surgery.

DISCUSSION:

Segmental resection of the perforated colon, rather than simple repair, appears to improve postoperative outcomes.

CONCLUSION:

As the number of cancer survivors increases, appropriate management of constipation is important to prevent stercoral perforation during follow-up.

Copyright © 2013 The Authors. Published by Elsevier Ltd.. All rights reserved.

KEYWORDS:

Colon; Colostomy; Stercoral perforation

PMID:
24121050
[PubMed]
PMCID:
PMC3825961
Free PMC Article
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