title: Colonic carcinoma with multiple small bowel perforations mimicking intestinal obstruction.
abstract: BACKGROUND
  Carcinoma of the colon may present with perforation proximal to the site of malignancy. Caecum is the commonest site of perforation if the ileocecal valve is patent and the jejunal and ileal perforations are very rare.
  
  
  METHODS
  A 35 year male presented with intestinal obstruction. Emergency laparotomy revealed carcinoma of the transverse colon with multiple pinpoint perforations along antimesenteric border of ileum, which were wrapped with omentum, and no peritoneal contamination was present. Extended right hemicolectomy with jejunocolic anastomosis was done. Patient made uneventful recovery in postoperative period and was treated with adjuvant chemotherapy.
  
  
  CONCLUSIONS
  Patients with colonic carcinoma and incompetent ileocecal valve may present with intestinal perforation. Increased intraluminal pressure and closed loop obstruction may lead to ischemia and perforation of the small bowel.
authors.affiliation: Department of General surgery, Institute of Medical Sciences, Banaras Hindu University, Varanasi-221005, India. drsktiwary1@gmail.com
authors.forename: Satyendra K
authors.initials: SK
authors.lastname: Tiwary
authors.forename: Manish K
authors.initials: MK
authors.lastname: Singh
authors.forename: Rahul
authors.initials: R
authors.lastname: Khanna
authors.forename: Ajay K
authors.initials: AK
authors.lastname: Khanna