A Case of Rectal Cancer with Rectal Perforation Caused by Press Through Package

Yukinori Kamio, Yukio Inaba, Shuichi Watabe, Motoi Koyama, Shinya Ohe, Ken-ichi Hayashi and Masakazu Chiba

Department of Surgery, Yamagata Prefectural Kahoku Hospital

An 84-year-old woman visited with abdominal pain and vomiting was admitted with a diagnosis of ileus. Rectal cancer was found 18 cm from the anus by colonoscopy, so her colonic ileus was due to the tumor. An ileustube was inserted into the colon from the anus and drainage started. Surgery was postponed due to liver dysfunction, but emergency surgery was done due to susected diffuse peritonitis due to colonic perforation. Surgery showed the rectum had been perforated caused by a Press Through Package (PTP) at the oral side of cancer, necessitating Hartmann's operation. Although 5 cases of colonic perforation have been reported in Japan, ours is the first of rectal perforation by PTP.

Key words
press through package, colonic perforation, perforative peritonitis

Reprint requests
Yukinori Kamio Department of Surgery, Yamagata Prefectural Kahoku Hospital 111 Yachi Gassandou, Kahoku-cho, Nishimurayama-gun, Yamagata, 999-3511 JAPAN

Accepted
June 25, 2002

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