Case Report
Copyright ©2006 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Gastroenterol. Jan 21, 2006; 12(3): 500-503
Published online Jan 21, 2006. doi: 10.3748/wjg.v12.i3.500
Management of patients with stercoral perforation of the sigmoid colon: Report of five cases
Wen-Shih Huang, Chia-Siu Wang, Ching-Chuan Hsieh, Paul Y Lin, Chih-Chien Chin, Jeng-Yi Wang
Wen-Shih Huang, Chih-Chien Chin, Jeng-Yi Wang, Division of Colon and Rectal Surgery, Chang Gung Memorial Hospital, Pu-tzu 613, Taiwan, China
Chia-Siu Wang, Ching-Chuan Hsieh, Division of General Surgery, Chang Gung Memorial Hospital, Pu-tzu 613 Taiwan, China
Paul Y Lin, Division of Anatomical Pathology, Chang Gung Memorial Hospital, Pu-tzu 613 Taiwan, China
Wen-Shih Huang, Graduate Institute of Clinical Medicine, Chang Gung University, Kwei-Shan, Taiwan, China
Correspondence to: Dr Wen-Shih Huang, Division of Colon and Rectal Surgery, Chang Gung Memorial Hospital, Pu-tzu 613 Taiwan, China. wshuang77@hotmail.com
Telephone: +886-5-3621000-2000 Fax: +886-5-3623001
Received: June 4, 2005
Revised: June 8, 2005
Accepted: June 24, 2005
Published online: January 21, 2006
Abstract

To our knowledge, stercoral perforation of the colon is rarely seen with fewer than 90 cases reported in the literature till date. We explored the principles of management to prevent impending mortality in five patients with this condition. Five patients, two males and three females, whose median age was 64 years, had sustained stercoral perforation of the sigmoid colon. Chronic constipation was the common symptom among these patients. Three patients underwent a Hartmann’s procedure and another two were treated with segmental colectomy with anastomosis and diverting colostomy. There was one surgical mortality and the other patients had an uneventful hospital stay. Timely intervention to prevent and/or treat any associated sepsis along with extensive peritoneal lavage and surgical intervention to remove diseased colonic tissue at the primary stercoral ulceration site coupled with aggressive therapy for peritonitis are key treatment modalities in salvaging patients presenting with stercoral perforation of the colon.

Keywords: Stercoral perforation, Colon, Management