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World Journal of Surgery

, Volume 5, Issue 1, pp 125–128 | Cite as

Idiopathic perforation of the sigmoid colon in Japan

  • Yoh Kasahara
  • Hiroki Matsumoto
  • Hiroya Umemura
  • Sei Shirafa
  • Takeshi Kuyama
Case Report

Abstract

This is a report of a case of idiopathic perforation of the sigmoid colon, a rare condition, and a review of 65 cases collected from the Japanese literature including our own. The ratio of males to females was 42∶23, the ages ranged from 16 to 87 years, and 68% of the patients were in the sixth decade or older. The perforation sites were in the middle of the sigmoid colon in 43 cases, of which 79% were at the antimesenteric border, and in the rectosigmoid region in 2 cases. Several pathogenetic factors are considered to be responsible for this perforation, among which constipation and raised intra-abdominal or intraluminal pressure may be most important. In the cases associated with constipation, differential diagnosis must be made by histologic examination. Free air under the diaphragm was noted on x-ray in 46% of patients and leukopenia under 4000/mm3in 35% of the cases. Only 2 patients with confined perforation were diagnosed preoperatively by barium enema x-rays. The overall mortality rate was 35%. Exteriorization or resection of the perforated site resulted in the best prognosis among the various operative procedures. There were 5 instances of colocutaneous fistula in 13 patients who underwent simple closure of the perforation.

Keywords

Barium Constipation Histologic Examination Thoracic Surgery General Surgery 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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Copyright information

© Société Internationale de Chirurgie 1981

Authors and Affiliations

  • Yoh Kasahara
    • 1
  • Hiroki Matsumoto
    • 1
  • Hiroya Umemura
    • 1
  • Sei Shirafa
    • 1
  • Takeshi Kuyama
    • 1
  1. 1.Second Department of SurgeryKinki University School of MedicineOsakaJapan

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