A Case of Traumatic Delayed Descending Colon Perforation Penetrating the Abdominal Wall

Shusaku Ohira, Hiroshi Hasegawa, Seiji Ogiso, Eiji Sakamoto, Tsuyoshi Igami, Toshiharu Mori, Kotaro Hattori, Takashi Mizuno, Masayuki Sugimoto and Yasuyuki Fukami

Department of Surgery, Nagoya Daini Red Cross Hospital

Traumatic delayed intestinal tract perforation is very rare, and may be caused by intestinal tract ischemia when blood circulation is obstructed in the mesenteric artery. We report a case in which the descending colon penetrated the body surface on the patient's side 13 days following an injury. The injury responded to medical treatment by drainage. A 31-year-old man who was burned in the abdomen in a traffic accident underwent dermatoplasty. On day 13 of hospitalization, a feces-like liquid exuded from the skingraft site on the left side of his abdomen. Imaging suggested that the descending colon was perforated. Since the burn site involved the entire abdomen, making laparotomy difficult, we inserted a drain and performed continuous suction. On day 109 of hospitalization, closing of the fistula was confirmed. This case is, to the best of our knowledge, the first report of its kind in Japan.

Key words
delayed intestinal tract perforation, blunt abdominal trauma, penetration to the abdominal wall

Reprint requests
Shusaku Ohira Department of Surgery, Nagoya Daini Red Cross Hospital 2-9 Myoken-cho, Showa-ku, Nagoya, 466-8650 JAPAN

Accepted
February 26, 2003

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