A Case of Idiopathic Perforation of the Sigmoid Colon with a Fecal Mass Formation in the Mesocolon

Yoshiaki Bando, Hiroshi Nishii, Kunio Ogasahara, Toshihiko Kondoh, Yoshinori Aoki and Norikazu Hanaki

Department of surgery, Takamatsu Municipal Hospital

A case of idiopathic perforation of the sigmoid colon with a fecal mass formation in the mesocolon due to penetration into the mesocolon is reported. A 76-year-old woman was hospitalized with the sudden lower abdominal pain, which was not very severe, and melena. She was referred to the surgery department because of the manifestation of the peritoneal sign during further examinations. An emergency operation was performed with the diagnosis of colonic perforation, because the abdominal CT showed gas at the retroperitoneal space and a low density area with air bubbles in front of the sacrum. Perforation was present in the mesenteric side of the sigmoid colon, and a fecal mass was formed as a result of penetration into the mesocolon. Hartmann's operation was performed with resection of the fecal mass and the retroperitoneal space with emphysema was opened for drainage. Her clinical course after the operation was uneventful. Idiopathic perforation of the colon with penetration into the mesocolon is rare. It is believed that a prognosis of colonic perforation without fecal peritonitis is good, as in our case.

Key words
idiopathic perforation of the sigmoid colon, penetration into the mesocolon

Reprint requests
Yoshiaki Bando Department of Surgery, Takamatsu Municipal Hospital 2-36-1 Miyawaki-cho, Takamatsu-shi, 760-8538 JAPAN

Accepted
July 28, 1999

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