Perforated solitary ulcer of the colon
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PURPOSE: A patient with a solitary colonic ulcer had sudden onset of crampy abdominal pain, anorexia, fever, and vomiting, with signs of positive peritoneal irritation. METHODS: The diagnosis was proved by histopathologic examination of right hemicolectomy material. RESULTS: An emergency laparotomy, with right hemicolectomy and ileotransversostomy, gave complete relief from symptoms. The patient was still asymptomatic at the two-year follow-up, and control colonoscopic examinations performed at 6 and 18 months after the operation were normal. CONCLUSION: Preoperative diagnosis of perforated solitary colonic ulcers localized at the right hemicolon may mimic acute appendicitis, and intraoperative findings may mimic colonic carcinoma. If the preoperative diagnosis is not certain, right hemicolectomy and ileotransversostomy, with regular colonoscopic controls, is a safe procedure in the treatment and follow-up of these patients.
Key wordsSolitary colonic ulcer Nonspecific colonic ulcer Surgical technique
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- 1.Earnest DL, Schneiderman DJ. Other diseases of the colon and rectum. In: Sleisenger MH, Fordtran JS, eds. Gastrointestinal disease: pathophysiology diagnosis management. Philadelphia: WB Saunders, 1989:1592–631.Google Scholar
- 2.Ona VF, Hector AD, Rocco V,et al. Diagnosis and management of nonspecific colon ulser. Arch Surg 1982;117:888–94.Google Scholar
- 3.Haraguchi M, Matsushima S, Fujie Y,et al. Nonspecific giant ulcer of the sigmoid colon: a case report. Jpn J Surg 1991;21:216–9.Google Scholar
- 4.Brock AL, Reynolds JD, Wood WG. Nonspesific ulcers of the colon: a case presentation of ulceration of the transverse colon. J Clin Gastroenterol 1979;1:241–5.Google Scholar
- 5.Wilcox CM, Schwartz DA. Idiopathic anorectal ulceration in patients with immunodeficiency virus infection. Am J Gastroenterol 1994;89:599–604.Google Scholar
- 6.Rubio CA, Nydahl S. “Nonspecific” erosions and ulcers of the colonic mucosa. Dig Dis Sci 1994;39:821–6.Google Scholar
- 7.Stoopack PM, Raufman JP. Aphthoid ulceration of the colon in strongyloidasis. Am J Gastroenterol 1991;86:639–42.Google Scholar
- 8.Iuchtman M, Heldenberg D, Auslaender L. Perforated nonspecific ulcer of the colon in children. Eur J Pediatr Surg 1991;1:372–3.Google Scholar