title: Stercoral perforation of the colon in sigmoid colostomy patients: Two case reports.
abstract: BACKGROUND
  Stercoral perforation of the colon has rarely been reported. Only 3 cases of stercoral perforation of the colon proximal to an end colostomy have been reported. We present two cases of stercoral perforation of the colon in end colostomy patients.
  
  
  METHODS
  A 70-year-old man who had undergone abdomino-perineal excision for anal cancer was referred for left lower quadrant pain and fever. Stercoral perforation was discovered along the distal descending colon, proximal to the end sigmoid colostomy. The patient underwent segmental resection of the colon and revision of the stoma and was discharged on postoperative day 32. A 71-year-old woman who had undergone abdomino-perineal excision for distal rectal cancer with preoperative chemoradiation presented fever with 2 days of low abdominal pain. The patient had sacral bone and lung metastases from rectal cancer and suffered from chronic constipation. Stercoral perforation was found around the sigmoid colon, just proximal to the end sigmoid colostomy. The patient underwent simple repair of the perforated colon through the parastomal incision. On postoperative day 8, leakage occurred at the repair site. Segmental resection of the colon and revision of the stoma were performed. She was discharged 44 days after the initial surgery.
  
  
  CONCLUSIONS
  Segmental resection of the perforated colon, rather than simple repair, appears to improve postoperative outcomes.
  
  
  CONCLUSIONS
  As the number of cancer survivors increases, appropriate management of constipation is important to prevent stercoral perforation during follow-up.
authors.affiliation: Department of Surgery, Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea.
authors.forename: Young Wan
authors.initials: YW
authors.lastname: Kim
authors.forename: Hyun Jun
authors.initials: HJ
authors.lastname: Kwon
authors.forename: Ik Yong
authors.initials: IY
authors.lastname: Kim
keywords: Colon; Colostomy; Stercoral perforation