Colonic contained perforation of unknown etiology treated conservatively in a 34 year old female patient: a case report
DOI:
https://doi.org/10.12775/JEHS.2022.12.07.046Keywords
Colon perforation, Surgery, Unknown origin, Conservative treatment, Contained perforationAbstract
A colon perforation is defined as a disruption in the continuity of the gastrointestinal wall. A contained perforation is a situation where the perforation is self-limited, usually by adhesion to other structures in the abdominal cavity. Many conditions can cause perforation, including cancer, diverticular disease, or iatrogenic perforation such as during an endoscopy procedure. Less commonly, the cause may be inflammatory bowel disease or the presence of a foreign body in gastrointestinal tract. Furthermore, there are also publications describing situations of spontaneous rupture of the intestinal wall, i.e. spontaneous perforations. This group includes spontaneous perforation caused by fecal stones and idiopathic perforation. In this article we present a case report of a 34 year old woman with perforation of the large intestine without any apparent cause. We discuss the differential diagnosis of patients with conservatively treated perforation with unknown colonoscopy result.
References
Jones MW, Kashyap S, Zabbo CP. Bowel Perforation. In: StatPearls. Treasure Island (FL): StatPearls Publishing; April 13, 2022. PMID: 30725909
Amini A, Lopez RA. Duodenal Perforation. In: StatPearls. Treasure Island (FL): StatPearls Publishing; May 1, 2022. PMID: 31971724
Pouli S, Kozana A, Papakitsou I, Daskalogiannaki M, Raissaki M. Gastrointestinal perforation: clinical and MDCT clues for identification of aetiology. Insights Imaging. 2020;11(1):31. Published 2020 Feb 21. doi:10.1186/s13244-019-0823-6
Simonetti I, Puglia M, Tarotto L, et al. When traditions become dangerous: Intestinal perforation from unusual foreign body-Case report and short literature review. Eur J Radiol Open. 2019;6:152-155. Published 2019 Apr 17. doi:10.1016/j.ejro.2019.04.002
Peters NA, Richel DJ, Verhoeff JJ, Stalpers LJ. Bowel perforation after radiotherapy in a patient receiving sorafenib. J Clin Oncol. 2008;26(14):2405-2406. doi:10.1200/JCO.2007.15.8451
Garg NK, Bagul NB, Doughan S, Rowe PH. Intestinal endometriosis--a rare cause of colonic perforation. World J Gastroenterol. 2009;15(5):612-614. doi:10.3748/wjg.15.612
Stupalkowska W, Mahler-Araujo B, Bennett J, Gourgiotis S. Spontaneous bowel perforation in the setting of colonic involvement with scleroderma. BMJ Case Rep. 2020;13(1):e233220. Published 2020 Jan 5. doi:10.1136/bcr-2019-233220
Namikawa T, Ozaki S, Okabayashi T, et al. Clinical characteristics of the idiopathic perforation of the colon. J Clin Gastroenterol. 2011;45(9):e82-e86. doi:10.1097/MCG.0b013e31820ca4c2
Cartwright SL, Knudson MP. Evaluation of acute abdominal pain in adults. Am Fam Physician. 2008;77(7):971-978. PMID: 18441863.
Amini, B., Carroll, D. Intussusception. Reference article, Radiopaedia.org. (accessed on 09 May 2022) https://doi.org/10.53347/rID-1526
Joshi G, Crawford KA, Hanna TN, Herr KD, Dahiya N, Menias CO. US of Right Upper Quadrant Pain in the Emergency Department: Diagnosing beyond Gallbladder and Biliary Disease. Radiographics. 2018;38(3):766-793. doi:10.1148/rg.2018170149
Aptilon Duque G, Mohney S. Appendicitis in Pregnancy. In: StatPearls. Treasure Island (FL): StatPearls Publishing; April 30, 2022. PMID: 31869106
Stauffer CM, Pfeifer C. Colonoscopy. In: StatPearls. Treasure Island (FL): StatPearls Publishing; May 13, 2022. PMID: 32644700
Ibrahim, D., Zinaye, A. CT colonography (protocol). Reference article, Radiopaedia.org. (accessed on 09 May 2022) https://doi.org/10.53347/rID-29924
Bhagatwala, J., Singhal, A., Aldrugh, S., Muhammed Sherid, M., Sifuentes, H., & Sridhar, S. (2015). Colonoscopy — Indications and Contraindications. In (Ed.), Screening for Colorectal Cancer with Colonoscopy. IntechOpen. https://doi.org/10.5772/61097
Ma T, Zheng W, An B, Xia Y, Chen G. Small bowel perforation secondary to foreign body ingestion mimicking acute appendicitis: Case report. Medicine (Baltimore). 2019;98(30):e16489. doi:10.1097/MD.0000000000016489
Greenstein AJ, Sachar DB, Mann D, Lachman P, Heimann T, Aufses AH Jr. Spontaneous free perforation and perforated abscess in 30 patients with Crohn's disease. Ann Surg. 1987;205(1):72-76. doi:10.1097/00000658-198701000-00013
Kambouri K, Gardikis S, Agelidou M, Vaos G. Local peritonitis as the first manifestation of Crohn's disease in a child. J Indian Assoc Pediatr Surg. 2014;19(2):100-102. doi:10.4103/0971-9261.129606
Casteleyn PP, Pector JC, Melon C. Acute free perforation as first sign of Crohn's disease. Acta Chir Belg. 1978;77(3):181-186. PMID: 676638
Coates M., Binion D., Silent Inflammatory Bowel Disease, Crohn's & Colitis 360, Volume 3, Issue 3, July 2021, otab059, https://doi.org/10.1093/crocol/otab059
Tomaszczyk M, Zwemer DA. Spontaneous free perforation of the distal ileum in Crohn's disease: case study. Int Surg. 2005;90(3 Suppl):S45-S47. PMID: 16463948.
Jamil L.,Alexander T., Spontaneous Colonic Perforation without Dilatation in a Patient with Ulcerative Colitis (UC) and the Role of Imaging Modalities in the Diagnosis of Colonic Perforation, American Journal of Gastroenterology: September 2005 - Volume 100 - Issue - p S247
Orholm M, Munkholm P, Langholz E, Nielsen OH, Sørensen TI, Binder V. Familial occurrence of inflammatory bowel disease. N Engl J Med. 1991;324(2):84-88. doi:10.1056/NEJM199101103240203
Childers RE, Eluri S, Vazquez C, Weise RM, Bayless TM, Hutfless S. Family history of inflammatory bowel disease among patients with ulcerative colitis: a systematic review and meta-analysis. J Crohns Colitis. 2014;8(11):1480-1497. doi:10.1016/j.crohns.2014.05.008.
Langhorst J, Elsenbruch S, Koelzer J, Rueffer A, Michalsen A, Dobos GJ. Noninvasive markers in the assessment of intestinal inflammation in inflammatory bowel diseases: performance of fecal lactoferrin, calprotectin, and PMN-elastase, CRP, and clinical indices. Am J Gastroenterol. 2008;103(1):162-169. doi:10.1111/j.1572-0241.2007.01556.x
Prado A, Cruz RP. Spontaneous Perforation of the Colon - A possible Third Classification. Rev Assoc Med Bras (1992). 2021;67(3):347-348. doi:10.1590/1806-9282.20200897
Al-Balas H, Al-Balas M, Al-Wiswasy M. Idiopathic spontaneous cecal perforation: A rare pathology with high mortality. Ann Med Surg (Lond). 2020;60:518-521. Published 2020 Nov 21. doi:10.1016/j.amsu.2020.11.047
Vodusek Z, Feuerstadt P, Brandt LJ. Review article: the pharmacological causes of colon ischaemia. Aliment Pharmacol Ther. 2019;49(1):51-63. doi:10.1111/apt.15052
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2022 Michalina Hordejuk, Aleksandra Marczak, Jakub Gołacki, Klaudia Sapuła, Klaudyna Iwaszko-Sochal
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
The periodical offers access to content in the Open Access system under the Creative Commons Attribution-NonCommercial-ShareAlike 4.0
Stats
Number of views and downloads: 664
Number of citations: 0