An Aged Case Who Experienced Idiopathic Perforation of the Colon Twice

Hideaki Karube, Hideki Masuda, Youichi Nakamura, Nobuhiko Aoki, Hisashi Nakayama, Fumii Sato, Kazuo Aizaki, Satomi Mita, Akihiro Henmi^* and Shigetomi Iwai^**

Department of Surgery, Department of Pathology^*, Nerima Hikarigaoka Hospital, Nihon University
Third Department of Surgery, Nihon University School of Medicine^**

It has been said that idiopathic perforation of the colon is rare and has a relatively poor prognosis. The patient in this case report was an 84-year-old woman who experienced an idiopathic perforation of the colon 2 years ago, and who underwent Hartmann's procedure. Now, at the age of 84, she was again admitted to a neighboring hospital, and was diagnosed with peritonitis. She was admitted to our hospital, with a blood pressure of 78/48 mmHg. Since abdominal plain radiography and CT examination indicated the free-air sign in the abdominal cavity, she underwent an emergency operation for intestinal perforation. At laparotomy, a perforation 3 cm in diameter was observed on the oral side 8 cm from the colostomy. Pathological diagnosis, was idiopathic perforation. We emphasize that early diagnosis and treatment are very important in cases with idiopathic perforation of the colon, particularly cases with advanced age.

Key words
idiopathic perforation of the colon, perforated peritonitis, aged patients

Reprint requests
Hideki Masuda Department of Surgery, Nerima Hikarigaoka Hospital, Nihon University 2-11-1 Hikarigaoka, Nerima-ku, Tokyo, 179-0072 JAPAN

Accepted
January 26, 2000

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