Management of patients with stercoral perforation of the sigmoid colon: report of five cases.
To our knowledge, stercoral perforation of the colon is rarely seen with fewer than 90 cases reported in the literature till date. We explored the principles of management to prevent impending mortality in five patients with this condition. Five patients, two males and three females, whose median age was 64 years, had sustained stercoral perforation of the sigmoid colon. Chronic constipation was the common symptom among these patients. Three patients underwent a Hartmannos procedure and another two were treated with segmental colectomy with anastomosis and diverting colostomy. There was one surgical mortality and the other patients had an uneventful hospital stay. Timely intervention to prevent and/or treat any associated sepsis along with extensive peritoneal lavage and surgical intervention to remove diseased colonic tissue at the primary stercoral ulceration site coupled with aggressive therapy for peritonitis are key treatment modalities in salvaging patients presenting with stercoral perforation of the colon.
Division of Colon and Rectal Surgery, Chang Gung Memorial Hospital, Pu-tzu 613 Taiwan, China. wshuang77@hotmail.com
Wen-Shih
WS
Huang
Chia-Siu
CS
Wang
Ching-Chuan
CC
Hsieh
Paul Y
PY
Lin
Chih-Chien
CC
Chin
Jeng-Yi
JY
Wang
D000368:Aged; D000369:Aged, 80 and over; D002675:Child, Preschool; D012809:Colon, Sigmoid / Q000473:pathology / Q000601:surgery*; D003248:Constipation / Q000209:etiology; D005260:Female; D006801:Humans; D007416:Intestinal Perforation / Q000150:complications / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies