A case of stercoral colonic perforation *
Stercoral colonic perforation is a relatively rare entity. This paper presents such a case in a 66-year-old woman. The patient was visited the hospital because of abdominal pain. Her abdomen was board-like, there was severe tenderness in the left lower quadrant, and bowel sounds were hypoactive. The abdominal x-ray film showed free air beneath the bilateral diaphragm. Lower gastrointestinal perforation and generalized peritonitis were diagnosed and an emergency operation performed. At laparotomy, the intestine from the descending colon to the rectum was filled with hard stool. A perforation was present in the sigmoid colon and, in the vicinity of the perforation, the stool mass had fallen away from the inside of the intestine. A Hartmann procedure was employed. On the resected material, the perforation was oval in shape. From operative and histopathological findings, a definite diagnosis of stercoral colonic perforation was made. The postoperative course was uneventful. Twelve months after the operation, closure of an artificial anus and an anastomosis between the descending colon and the rectum were performed. (Accepted on October 18, 2002) Kawasaki Igakkaishi 28(4) : 297―301, 2002
