title: Seromuscular tear of the sigmoid colon in the absence of trauma: a case report.
abstract: A 16-year-old adolescent boy was admitted to our hospital with severe lower abdominal pain and was found to have peritonitis, probably caused by acute appendicitis. At laparotomy, we found a paper-thin, dilated sigmoid colon; the seromuscular layer on the antimesenteric side was torn, and the untorn mucosa showed a pinpoint perforation. The seromuscular defect had spread circumferentially to involve the entire circumference of the colon wall. We performed sigmoidectomy, and the patient recovered uneventfully. This case showed many similarities, both in terms of the macroscopic and pathological findings, to seromuscular tear, an entity specifically associated with seatbelt use. This case is noteworthy because seromuscular tear-like lesions of the colon without a history of trauma has not previously been reported.
authors.affiliation: Surgery for Organ Function and Biological Regulation, Graduate School of Medicine, Nippon Medical School, Bunkyo-ku, Tokyo, Japan. nomura-t@nms.ac.jp
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Nomura
authors.forename: Masao
authors.initials: M
authors.lastname: Miyashita
authors.forename: Itsuro
authors.initials: I
authors.lastname: Fujita
authors.forename: Hideyuki
authors.initials: H
authors.lastname: Suzuki
authors.forename: Kiyonori
authors.initials: K
authors.lastname: Furukawa
authors.forename: Takashi
authors.initials: T
authors.lastname: Tajiri
mesh_terms: D000293:Adolescent; D012809:Colon, Sigmoid / Q000601:surgery*; D006801:Humans; D007416:Intestinal Perforation / Q000473:pathology / Q000601:surgery*; D008297:Male; D012422:Rupture, Spontaneous; D012810:Sigmoid Diseases / Q000473:pathology / Q000601:surgery*; D016896:Treatment Outcome