How to diagnose and treat spontaneous colonic perforation?

October 13, 2008

Spontaneous perforation of the colon is defined as a sudden perforation of the normal colon without any diseases such as tumor external injury. It is rare, often misdiagnosed and has a high mortality rate. A group led by Huai-Kun Ni from Fuding City Hospital of China investigated the etiology, diagnosis and treatment of spontaneous perforation of the colon, and this will be published on July 28, 2008 in the World Journal of Gastroenterology.

They retrospectively analyzed the clinical data of 10 cases of spontaneous perforation of the colon, observed at Fuding hospital from January 2004 to December 2007. Seven patients had a history of chronic constipation. All patients complained of sudden lower abdominal pain. The perforation occurred after coloclysis and administration of senna leaves in two patients. Nine patients had signs of peritoneal irritation. Seven cases underwent abdominal paracentesis, which was diagnostic in six. Only one case was definitely diagnosed prior to surgery. One patient underwent neoplasty of the colon, another a partial resection of colon, six a neoplasty of the colon plus sigmoid colostomy, and two underwent Hartmann surgery. All perforation sites were opposite to the mesenteric edge. The perforation sites were located on descending colon in one case, sigmoid colon in three cases, and rectosigmoid colon in six cases. In five patients, surgical pathological examination was consistent with the microscopical changes of colonic perforation caused by feces. Three patients died after surgery. This study may be helpful for the diagnosis and treatment of spontaneous colonic perforation.
Reference: Yang B, Ni HK. Diagnosis and treatment of spontaneous colonic perforation: An analysis of 10 cases. World J Gastroenterol 2008; 14(28): 4569-4572

Correspondence to: Huai-Kun Ni, Department of General Surgery, City Hospital of Fuding, Fuding 355200, Fujian Province, China. Telephone: +86-593-7832030 Fax: +86-593-7862665

About World Journal of Gastroenterology

World Journal of Gastroenterology (WJG), a leading international journal in gastroenterology and hepatology, has established a reputation for publishing first class research on esophageal cancer, gastric cancer, liver cancer, viral hepatitis, colorectal cancer, and H pylori infection and provides a forum for both clinicians and scientists. WJG has been indexed and abstracted in Current Contents/Clinical Medicine, Science Citation Index Expanded (also known as SciSearch) and Journal Citation Reports/Science Edition, Index Medicus, MEDLINE and PubMed, Chemical Abstracts, EMBASE/Excerpta Medica, Abstracts Journals, Nature Clinical Practice Gastroenterology and Hepatology, CAB Abstracts and Global Health. ISI JCR 2003-2000 IF: 3.318, 2.532, 1.445 and 0.993. WJG is a weekly journal published by WJG Press. The publication dates are the 7th, 14th, 21st, and 28th day of every month. WJG is supported by The National Natural Science Foundation of China, No. 30224801 and No. 30424812, and was founded with the name of China National Journal of New Gastroenterology on October 1, 1995, and renamed WJG on January 25, 1998.

About The WJG Press

The WJG Press mainly publishes World Journal of Gastroenterology.

World Journal of Gastroenterology

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