Idiopathic spontaneous cecal perforation: A rare pathology with high mortality
| العنوان: | Idiopathic spontaneous cecal perforation: A rare pathology with high mortality |
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| المؤلفون: | Mohammad Al-Wiswasy, Mahmoud Al-Balas, Hamzeh Al-Balas |
| المصدر: | Annals of Medicine and Surgery |
| بيانات النشر: | Elsevier, 2020. |
| سنة النشر: | 2020 |
| مصطلحات موضوعية: | Abdominal pain, medicine.medical_specialty, medicine.medical_treatment, Perforation (oil well), Spontaneous Perforation, Rectum, Peritonitis, Case Report, 03 medical and health sciences, Ileostomy, 0302 clinical medicine, medicine, Surgical emergency, Cecal perforation, business.industry, General Medicine, medicine.disease, Surgery, medicine.anatomical_structure, 030220 oncology & carcinogenesis, Spontaneous perforation of the colon, 030211 gastroenterology & hepatology, medicine.symptom, business, Rare disease |
| الوصف: | Introduction Spontaneous perforation of the colon (SPC) is a rare disease characterized by sudden perforation of a clinically healthy colon in the absence of underlying disease or trauma. The aim of reporting this case is to highlight this surgical emergency in terms of clinical presentations, surgical management and outcomes. Presentation of case A 68 year-old male with history of diabetes mellitus, hypertension and chronic constipation on daily laxatives presented to the emergency department with a diffuse abdominal pain and distention for 4 days associated with vomiting and absence of defecation where he was prescribed phosphate rectal enemas. Patient was in sepsis with generalized abdominal tenderness and distention. Intraoperative findings of feculent peritonitis with isolated cecal perforation was identified, for which a right hemicolectomy with end ileostomy was performed. Discussion The first case was described in a woman presented with spontaneous rectum rupture by Brodie in 1827, with a less than 100 cases being reported in literature. In 1984, spontaneous perforations were classified into either “stercoral” or “idiopathic” perforations. More than 60% of colonic perforations were reported in the sigmoid or at the recto-sigmoid junction, mainly at the anti-mesenteric border, making spontaneous cecal perforation a very uncommon condition. Cecal perforation is associated with high mortality in the range of 30%–72%. Conclusion The outcome of SPC depends on multiple factors like onset of perforation, peritoneal contamination, and time of intervention. Regardless the surgical technique, early detection and surgical management are the main strategies associated with improving the outcomes. Highlights • Spontaneous perforation of the cecum can be classified as sterocral or idiopathic perforations. • Early recognition of the pathology and prompt intervention is critical for management. • A high mortality rates associated with cecal perforation might be related to the delay of diagnosis. • No surgical intervention is reported to be superior in terms of mortality. |
| اللغة: | English |
| تدمد: | 2049-0801 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::91334a4988bf5de002e907d2fafe2050 http://europepmc.org/articles/PMC7695924 |
| حقوق: | OPEN |
| رقم الأكسشن: | edsair.doi.dedup.....91334a4988bf5de002e907d2fafe2050 |
| قاعدة البيانات: | OpenAIRE |
Full Text via ClinicalKey | تدمد: | 20490801 |
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