A Case of Stercoral Perforation of the Ascending Colon

Kazuhiro Sakamoto¹⁾³⁾, Kazuhito Tsuchida¹⁾³⁾, Akihiko Yasumoto²⁾, Takamitsu Ariga²⁾, Yasushi Rino³⁾ and Yoshinori Takanashi³⁾

¹⁾Department of Respiratory Surgery and ²⁾Surgery, Yokohama Rosai Hospital
³⁾First Department of Surgery, Yokohama City University School of Medicine

Stercoral perforation of the colon is rare, and is usually found in the rectosigmoid region. We report stercoral perforation of the ascending colon. A 77-year-old man, who had a right lower lobectomy 9 months previously for lung cancer, was admitted due to pneumothorax, and a chest tube was put in place. He suffered sudden abdominal pain 2 days after admission. Abdominal radiography showed free air under the diaphragm. Abdominal computed tomography (CT) showed impressive dilation of the ascending colon, which contained massive amounts of stool. We conducted emergency laparotomy for generalized peritonitis, suspecting stercoral perforation of the colon. Several oval perforations were discovered on the anterior wall of the ascending colon, and feces were found iin the peritoneal cavity. We conducted right colectomy and reanastomosis. Histopathologically, necrosis and several perforations were identified in the resected ascending colon. The patient's postoperative course was uneventful except for temporary delirium, and he was discharged on postoperative day 15.

Key words
stercoral perforation, colon, peritonitis

Reprint requests
Kazuhiro Sakamoto First Department of Surgery, Yokohama City University School of Medicine 3-9 Fukuura, Kanazawa-ku, Yokohama, 236-0004 JAPAN

Accepted
June 25, 2002

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